The New Couple Dynamics at the Time of Covid-19: How the Sexual Health of Male and Female Individuals Has Changed during the Pandemic

INTRODUCTION AND OBJECTIVE: The current pandemic has forced the population to experiencing negative psychological reactions and changes in sexual behavior. The aim of our study is to investigate how the sexual health of male and female individuals has changed during the COVID pandemic period. METHOD(S): We conducted a retrospective cohort study with an anonymous survey using the Google Forms platform on a population of individuals of both sexes. Participants were spontaneously enrolled and asked to answer questions regarding their sexual health and habits during the pre-pandemic (T0) and a pandemic (T1) period. Participants were stratified into four age groups: G1 (18-35 yo), G2 (36-50 yo), G3 (51-60 yo), and G4 (61-70 yo). Male and female patients' sexual function was evaluated with IIEF-15 questionnaire and FSFI questionnaire, respectively;both populations responded to the CSFQ- 14 questionnaire. Data were compared between groups reporting the mean standard deviation (SD). Results were compared with the analysis of variance (ANOVA) and the mean scores of the questionnaires were analyzed with the Wilcoxon test. RESULT(S): 244 patients, 144 males and 100 females spontaneously participate to the survey. Overall, IIEF-15 score in the general population at T1 were lower than T0 (58.95+/-15.8 vs 62.44+/-11.1, p<0.001). However, considering results divided by age groups, there was a statistically significative difference only in the younger age group (G1: 58.22+/-16.9 vs 63.41+/-9.7, p<0.0001). Regarding the female subjects, the statistical analysis showed that the differences between T0 and T1 were not statistically significative both for the total population (p=0.9) and for the different age groups. Analyzing the single items of FSFI, Q15 (mean 2.77+/-1.6 vs 2.46+/-1.5, p<0.005) and Q16 (mean 2.87+/-1.5 vs 2.46+/-2.4, p<0.0001) that are part of the Satisfaction domain, demonstrated a significative differences between groups. In both gender groups there was no differences in CSFQ-14 at T0 and T1. CONCLUSION(S): During the pandemic period, the male population in our study reported an impairment in the sexual function. However, in female individuals there were no variations in the two periods analyzed. The COVID-19 pandemic has played a role in changing couple dynamics and more research will be necessary to study the effects on the sexual health of the affected population.

Evaluation of sexual function and sexual quality of life in women during the COVID-19 Pandemic: the Turkish case

Background: Sexual health is an important component of general health. Objective(s): To evaluate sexual function and sexual quality of life (SQOL) in women during the COVID-19 pandemic. Method(s): This descriptive, cross-sectional study was conducted in Turkey. Data were collected via a Visual Analog Scale (VAS), Female Sexual Function Index (FSFI), and Sexual Quality of Life-Female (SQOL-F) questionnaire. Result(s): The mean FSFI score was 26.91+/-5.62, and 39.1% of the women had an FSFI score of 26.55 or lower. The mean SQOL-F score was 79.08+/-20.90. FSFI score was significantly associated with employment status (beta=-0.661), partner education (beta=1.698), sexual compatibility between partners (beta=0.518), sexual satisfaction (beta=0.230), fatigue level (beta=-0.120), and frequen-cy of sexual intercourse (beta=0.160). In addition, SQOL-F score was significantly associated with sexual desire (beta=2.625), satisfaction (beta=1.338), pain or discomfort (beta=1.274), age (beta=-0.356), sexual compatibility between partners (beta=1.984), and fatigue level (beta=-0.981) (p<0.05). Conclusion(s): Less than half of the women participating in this study had sexual dysfunction, and overall SQOL was moderate to high. These results were associated with some descriptive characteristics of the women and were similar to those reported in pre-pandemic studies conducted in Turkey.Copyright © The Authors.

The Effect of Covid-19 Anxiety on Sexual Function of Healthcare Providers-a Cross-Sectional Survey Study

Objective. Coronavirus disease epidemic in 2019 (COVID-19) posed a big challenge to healthcare providers. The present study aimed to explore the relationship between coronavirus anxiety and the sexual function of healthcare providers. Methods. In this study, an online survey was used to explore the relationship between anxiety and sexual function in healthcare providers during COVID-19 pandemic. The questionnaire included Female Sexual Function Index (FSFI) and Corona Disease Anxiety Scale (CDAS). Results. A total of 300 healthcare providers were investigated in this study. The estimated self-reported rates of mild anxiety symptoms were 49%, moderate 29.2% and severe were 29.9%. The total mean score of FSFI of healthcare providers were 19.1 (SD=4.4). The results showed that on the total scale, 40.9% of healthcare providers had mild anxiety. The results also indicated that female sexual function is inversely correlated with anxiety during COVID-19 pandemic. Also, it was shown that anxiety during COVID-19 is inversely correlated with sexual functioning. Conclusion. This study presented the negative impact of the COVID-19 pandemic on anxiety and sexual function in healthcare providers. Therefore, psychological or sexual assistance may be beneficial.Copyright © 2022, Serbian Medical Society. All rights reserved.

Sexual Health During COVID-19: A Scoping Review.

INTRODUCTION: The COVID-19 pandemic impacted profoundly on the wellbeing and social interactions of the world population, and all dimensions of sexual health were potentially affected by globally implemented preventive measures. OBJECTIVES: The scoping review aimed to compile existing research investigating possible effects of COVID-19 lockdowns on adult sexual health, that is, sexual behavior, functioning, and satisfaction. Further, studies on the interplay between mental health and sexual well-being during the pandemic were reviewed. METHODS: The review was conducted in accordance with guidelines established by the Joanna Briggs Institute and the Extension for Scoping Reviews (PRISMA-ScR) Checklist. On October 11-12, 2021, PubMed, Embase, PsycInfo, Cinahl, Cochrane, Sociological Abstracts and Scopus were systematically searched for relevant peer-reviewed papers employing quantitative methodology. Additionally, unpublished ("grey") research studies on the subject were retrieved. The screening, data extraction, and analysis of evidence were conducted by 4 independent reviewers using an iterative approach. RESULTS: Based on 107 studies included, the scoping review showed that the pandemic had had a wide impact on all dimensions of sexual health. Except for solo sex activities, mainly negative COVID-19 implications were identified, although findings were, in sum, characterized by complexity and unpredictability. Thus, sexual behavior, functioning, and satisfaction during the pandemic appeared to be mitigated by a broad range of sociodemographic and contextual factors. Finally, sexual health seemed deeply entwined with overall mental health. CONCLUSION: The scoping review revealed a broad range of COVID-19-related effects on sexual health, including an overall decline in partnered sex and a concurrent increase in solo sex activities. It also emphasized a need for future research to shed light on possible long-term consequences of the pandemic in various population groups and on all aspects of sexual health.

The effect of coronavirus disease 2019 severity on male sexual functions among patients on follow-up after hospital discharge

Objectives Severe acute respiratory syndrome coronavirus 2 has infected millions of people worldwide with extensive affection and damage to body systems and organs;hence, the study of post-coronavirus disease (COVID) sequences is mandatory. Till now, reports are upcoming on the considerable effects of COVID-19 on male sexual health with no final data. Patients and Methods: Our cohort study included 76 male COVID-19-infected patients, confirmed positive via nasopharyngeal PCR swab. The rationale of this study was to estimate the influence of clinical, laboratory, and radiological severity parameters of COVID-19 on male erectile dysfunction based on erectile scores and male sex hormones (follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol). Result(s): Our results have demonstrated a highly statistically significant correlation between COVID-19 severity (mild, moderate, and severe cases) and both erectile scores (erection hardness score and International Index of Erectile Dysfunction-5) and testosterone hormones at first and third month after COVID (P0.001), except for testosterone level at third month and COVID-19 severity, which showed a statistically significant difference, with P value of 0.031. Conclusion(s): The current study correlated the effect of COVID-19 severity in the terms of clinical, laboratory, and radiological presentations on male sexual dysfunction (erectile scores and testosterone hormone) at first and third month after hospital discharge, with statistical significance being highly affected in severe rather than moderate and mild cases. This strengthens the obvious effect of COVID-19 infection on male sexual dysfunction. Copyright © 2023 The Egyptian Journal of Chest Diseases and Tuberculosis.

Psychological status of infertile men during the Coronavirus Disease 2019 Pandemic in China: a cross-sectional investigation.

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak has had a widespread and profound impact on people's mental health. The factors associated with mental symptoms among men diagnosed with infertility, a disease closely related to psychological conditions, remain unclear. The aim of this study is to investigate the risk factors associated with mental symptoms among infertile Chinese men during the pandemic. RESULTS: A total of 4,098 eligible participants were recruited in this cross-sectional, nationwide study, including 2,034 (49.6%) with primary infertility and 2,064 (50.4%) with secondary infertility. The prevalence of mental health conditions was 36.3%, 39.6%, and 6.7% for anxiety, depression, and post-pandemic stress, respectively. Sexual dysfunction is associated with a higher risk with adjusted odds ratios (ORs) of 1.40 for anxiety, 1.38 for depression, and 2.32 for stress. Men receiving infertility drug therapy displayed a higher risk for anxiety (adjusted OR, 1.31) and depression (adjusted OR, 1.28) symptoms, while those receiving intrauterine insemination had a lower risk of anxiety (adjusted OR, 0.56) and depression (adjusted OR, 0.55) symptoms. CONCLUSION: The COVID-19 pandemic has had a significant psychological impact on infertile men. Several psychologically vulnerable populations were identified, including individuals with sexual dysfunction, respondents receiving infertility drug therapy, and those experiencing control measures for COVID-19. The findings provide a comprehensive profile of the mental health status of infertile Chinese men during the COVID-19 outbreak and provide potential psychological intervention strategies.

RéSUMé: CONTEXTE: L'épidémie de maladie à coronavirus 2019 (COVID-19) a eu un impact étendu et profond sur la santé mentale des gens. Les facteurs associés aux symptômes mentaux chez les hommes diagnostiqués comme infertiles, une maladie étroitement liée aux conditions psychologiques, restent flous. L'objectif de cette étude est d'étudier les facteurs de risque associés aux symptômes mentaux chez les hommes chinois infertiles pendant la pandémie. RéSULTATS: Au total, 4 098 participants admissibles ont été recrutés dans cette étude transversale à l'échelle nationale, dont 2 034 (49,6%) présentaient une infertilité primaire et 2 064 (50,4%) une infertilité secondaire. La prévalence des problèmes de santé mentale était respectivement de 36,3 %, 39,6 % et 6,7 % pour l'anxiété, la dépression, et le stress postpandémique. La dysfonction sexuelle est associée à un risque plus élevé avec des odds ratios ajustés (OR) de 1,40 pour l'anxiété, 1,38 pour la dépression et 2,32 pour le stress. Les hommes recevant un traitement médicamenteux contre l'infertilité présentaient un risque plus élevé de symptômes d'anxiété (OR ajusté, 1,31) et de dépression (OR ajusté, 1,28), alors que ceux dont le traitement consistait à faire des inséminations intra-utérines présentaient un risque plus faible de symptômes d'anxiété (OR ajusté, 0,56) et de dépression (OR ajusté, 0,55). CONCLUSIONS: La pandémie de COVID-19 a eu un impact psychologique important sur les hommes infertiles. Plusieurs populations psychologiquement vulnérables ont été identifiées, notamment les personnes souffrant de dysfonction sexuelle, les hommes recevant un traitement médicamenteux contre l'infertilité, et ceux subissant des mesures de contrôle de la COVID-19. Les résultats fournissent un profil complet de l'état de santé mentale des hommes Chinois infertiles pendant l'épidémie de COVID-19 et fournissent des stratégies potentielles d'intervention psychologique.

The Impact of the COVID-19 Pandemic on Female Sexual Function in Jordan: Cross-sectional Study.

BACKGROUND: Sexual function is a complex physiological process controlled by neurovascular and endocrine mechanisms that are affected by stressful events. The sexual response cycle consists of four main phases, which are sexual desire or libido, arousal or excitement, orgasm, and resolution. The COVID-19 outbreak is one of the most stressful events historically, causing several unpleasant consequences, including major physical and mental disorders, and sexual dysfunction and alteration in sexual behavior are possible anticipated consequences of the pandemic. Moreover, there are social taboos related to sexual behavior in Jordan, and the current knowledge on changes in Jordanian female sexual function during COVID-19 pandemic is limited. OBJECTIVE: This study aims to evaluate the impact of COVID-19 on women's sexual function during the early COVID-19 pandemic in Jordan. METHODS: This is a cross-sectional study that employed a web-based survey to follow 200 female individuals from the general population in Jordan. The survey evaluated sexual function both during COVID-19 and 6 months prior to the pandemic. The primary outcomes investigated in this study were the changes in sexual intercourse frequency and sexual function aspects, including desire, arousal, satisfaction, orgasm, lubrication, and pain during sexual activity. Data were analyzed using paired t test, McNemar test, Pearson correlations, and multiple linear regression using SPSS 25. RESULTS: During the COVID-19 pandemic, the participants' sexual intercourse frequency increased while their sexual satisfaction was significantly changed. The proportion of participants who had 0-2 times per week of sexual intercourse was decreased during the COVID-19 pandemic compared with that before the pandemic (n=90, 45% vs n=103, 51.5%; P=.02). Conversely, the number of female individuals with 3-7 times per week of sexual intercourse increased after the pandemic compared with the prepandemic state (n=103, 51.5% vs n=91, 45.5%; P=.04). Female sexual satisfaction was significantly reduced after the COVID-19 pandemic compared with that before the pandemic (3.39 vs 3.30; P=.049). The other categories of sexual function, including desire, arousal, satisfaction, orgasm, lubrication, and dyspareunia showed no significant changes during the COVID-19 pandemic compared with the previous 6 months. There were no significant differences between the total sexual function mean scores during COVID-19 (15.73) compared with the prepandemic scores (15.85; P=.41). The total score of female sexual function during the pandemic was negatively associated with the participants' age and education level. Correlations between various demographics and sexual function categories during the COVID-19 pandemic were identified. CONCLUSIONS: This is the first study exploring female sexual function during the COVID-19 outbreak in Jordan. The results suggest that COVID-19-associated stress is influencing women's sexual function, necessitating the provision of adequate emotional and physiological well-being support for women during similar crises.

Efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19: A randomized placebo-controlled trial.

Objective: According to the high prevalence of coronavirus disease (COVID-19) and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19. Methods: In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF) questionnaire. Then, treatment was started from two months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group. Results: Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (p<0.05). Conclusions: Daily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.

COVID-19 Quarantine and Sexual Function after First Vaginal Delivery.

OBJECTIVES: Sexual function is an important part of quality of life at all ages. Childbirth brings many changes that may affect sexual function. During COVID-19 global pandemic, nuclear families were forced to stay home. The goal of this study was to evaluate sexual function during the COVID-19 quarantine, in postpartum couples in the first months following their first vaginal childbirth. DESIGN: This is a single-center, prospective study of females following their first vaginal delivery and their male partners. Participants were recruited in the maternity ward after their first delivery at Rambam Medical Center. Both spouses signed a consent form for answering the sexual function questionnaires. PARTICIPANTS: Participants were interviewed by telephone during the last week of the first COVID-19 quarantine, according to Arizona Sexual Experience Scale (ASEX). MAIN OUTCOME MEASURES: pre- and post-quarantine sexual function according to ASEX scores. ASEX is a survey that assesses sexual drive, arousal, vaginal lubrication, the ability to reach orgasm, and satisfaction from orgasm. Responses are scored on a 1-6 Likert scale with a potential range of 5-30, where the highest scores indicate worse sexual function. RESULTS: The participants were 38 women and 29 men. The average time from delivery to the interviews was 182.8 ± 84.7 days; 56% of the spouses were under quarantine. The median baseline total ASEX score was 13 (sexual drive 3, arousal 2.5, vaginal lubrication 2.5, ability to reach orgasm 2, orgasm satisfaction 2) for women and 11 (sexual drive 3, arousal 2, penile erection 1, ability to reach orgasm 2, orgasm satisfaction 2) for men. Sixteen percent of the women and none of the men had a baseline sexual dysfunction (ASEX score >19). Significant differences were not observed in total ASEX scores before and during the quarantine. LIMITATIONS: Sexual function at the end of the quarantine was evaluated prospectively and pre-quarantine sexual function was evaluated retrospectively, with the limitation of recall bias. CONCLUSIONS: COVID-19 quarantine did not seem to have a significant effect on female or male sexual function, three to 9 months after the first vaginal delivery. The current study is the first to describe primiparous postpartum sexual function as median ASEX score.

Effects of COVID-19 Lockdown on People's Sexual Lives in Turkiye

Objective: To evaluate the impact of coronavirus disease-2019 (COVID-19) lockdown on the sexual lives of couples who live in Turkiye. Material(s) and Method(s): One hundred ninety-three sexually active participants. While sexual functions were evaluated with the international erectile function index-15 in men and the female sexual function index in women, Hamilton anxiety scale (HAM) was used to measure anxiety level. Married people filled out the Marriage adjustment test (MAT) questionnaire. The effects of the quarantine period on the relationship were evaluated with a questionnaire created specifically for this study. Result(s): Sexual improvement and worsening were observed in 8.8%, and 15%, respectively. It did not change for 76.2%. Sexually deteriorated subjects had a higher HAM score (p=0.003). The MAT score was lower in sexually deteriorated subjects (p=0.004). The rate of sexual worsening was higher in women than in men (28.6% vs. 12%, p=0.02). Women's HAM scores were higher (p=0.002). The MAT score was also found to be higher in women (p=0.0037). 58% of sexually deteriorated participants did not feel safe at home during the COVID-19 period, whereas all of those sexually improved participants felt safe at home. Conclusion(s): During the COVID-19 lockdown period, sexual deterioration was detected in 15% of sexually active people. This worsening was associated with the HAM score. Additionally, it was revealed that feeling safe at home is related to sexual life. While the relationship between sexually worsening and the MAT score was significant in men, it was revealed that the level of anxiety in women affected sexual life more significantly. © Copyright 2022 by the Association of Urological Surgery / Journal of Urological Surgery published by Galenos Publishing House.

COVID-19 Pandemic and Its Impact on the Quality of Women's Sexual Life: A Systematic Review.

The COVID-19 pandemic has had far-reaching effects, including onphysical and mental health and wellbeing. The aim of this study was to investigate the effect of the COVID-19 pandemic on women's health, especially on women's sexual life includingdesire, arousal, orgasm and satisfaction. The initial research in PubMed/Medline, Google Scholar and Scopus yielded 573 articles from Europe (Portugal, Poland, Italy, Greece), America (U.S, Brazil) and Africa (Egypt), of which 14 met the inclusion criteria and were included in the review. Results from the studies suggest that the pandemic negatively affected sexual functioning and satisfaction, while it increased sexual distress, sexual avoidance and solitary sexual approach behaviors. The desire to have children decreased during the pandemic, but so didthe use of contraception. There is conflicting evidence as to whether or not the pandemic has had an impact on sexual desire and frequency among women. However, some major factors associated with sexual life were psychological factors and working status. It is well documented that the pandemic has had a great psychological impact. Therefore, both of these factors are expected to significantly affect women's sexual life.

Assessing sexual health status among Tunisian ICU healthcare providers in times of the COVID-19

Introduction: The COVID-19 pandemic has dramatically affected ones well-being. ICU healthcare providers are particularly concerned by this impact which includes physical, mental and socioeconomic repercussions. Others health dimensions could be deeply affected but not well explored such as the psycho-sexual status. Objective(s): The aim of this study was to assess sexual health status among ICU healthcare providers. Method(s): This was a cross-sectional study enrolling Tunisian ICU healthcare providers and conducted between July and September 2021.Data collectionwas based on a self-administrated questionnaire. To assess sexuality, Arabic validated versions of the IIEF-15 and the FSFI was used formale and female respectively. The Fear of COVID- 19 Scale and the Rosenberg Self-esteemquestionnaire were also used. Result(s): Twenty ICU workers (13 physicians and 7 nurses) were enrolled. The mean age was 28.2 years and the sex ratio was 2.3. All participants were involved in COVID-19 crisis management and 80 % reported an increase in their workload. The mean Rosenberg scale was 27 suggesting a low self-esteem. The mean Covid19 Fear Scale was 26 +/- 2. For the IIEF-15 the mean score was 17 +/- 3 (moderate erectyl dysfunction) and the most damaged dimension was the intercourse satisfaction. For the FSFI scale, the mean was 23+/-5 witch (a low sexual dysfunction). A high sexual desire with a lack in the satisfaction dimension was reported in 90% of cases. Only 4 participants have consulted a sexologist. Conclusion(s): COVID-19 has a serious sexual impact in ICU healthcare providers justifying urgent psychological interventions.

Sexuality in women recovered from COVID-19

Introduction: While several studies have assessed the impact of the COVID-19 pandemic on sexuality and sexual behavior in the general population, very few studies have assessed sexuality after Sars-Cov 2 infection. Objective(s): The objective of our study were to assess sexuality in women recovered from COVID-19 and to compare it to healthy controls. Method(s): This is a cross-sectional case-control study. We randomly recruited women, from April 1st to 30th, 2021.The women in the case group have been infected with Sars-Cov 2, with a benign or pauci-symptomatic clinical form, and cured for one to two months at the time of the study without any post-COVID complications. Women included in the control group have not been infected with Sars-Cov 2. Sexuality was assessed by the Female Sexual Function Index (FSFI). Result(s): In total, we recruited 30 women in the case group and 30 women in the control group.The average age of the case group was 35.8 +/-6.8 years versus an average age of 35.3 +/- 6.33 years in the control group. The majority of coronavirus infections were symptomatic (83.3% (n=25)). An FSFI score <26.55 and corresponding to impaired sexual function was found in 63.33% of women in the case group (n=19), versus 53.33% of women in the control group (n=16) with a significant difference between the two groups (p=0.009) Conclusion(s): COVID-19 is significantly associated with sexual dysfunction, even in mild or pauci-symptomatic clinical forms.

Measured subjective differences in intensity of clitoral and vaginally activated orgasm

Objectives: We aimed to investigate the difference in perceived intensity of orgasm among women experiencing clitoral or vaginally activated orgasm (VAO). Method(s): We reviewed data from the Sex@COVID online survey (Mollaioli et al, J Sex Med. 2021 Jan;18(1):35-49) to retrieve a sample of heterosexual Italian sexually active female subjects. Several validated questionnaires and inventories were used to investigate sexual and psychological health (GAD-7, Lowe et al, Med Care 2008;46:266-274;PHQ-9, Kroenke et al, J Gen Intern Med 2001;16:606-613;FSFI, Rosen et al, J Sex Marital Ther 2000;26:191-208). Result(s): 1207 women were included in analysis: 346 were in a non-cohabiting relationship (Group A, 28.7%), 581 were in a cohabiting relationship (Group B, 48.1%) and 280 were married (Group C, 23.2%). 40.9% of the study population reported being able to orgasm through both clitoral stimulation and vaginal penetration (n = 494), 35.4% through clitoral stimulation (n = 427) and 20.1% through vaginal stimulation (n = 243). Additionally, 3.6% (n = 43) reported being unable to reach orgasm at all. By analysis of variance, following adjustment for FSFI, PHQ-9, GAD-7 and age, women experiencing no orgasm had lower orgasmometer scores (beta = -0.75, p <0.001), and VAO were associated with higher orgasmic intensity compared to clitoral orgasms (beta = 0.10, p = 0.008). Experiencing both orgasms had no effect compared to VAO (beta = 0.03, p = 0.545). Women who preferred reaching orgasm through masturbation to partnered sexual activity had lower orgasmic intensity (beta = -0.28, p = 0.002). Groups B and C had better orgasmic intensity compared to group A (beta = 0.08, p = 0.009). Conclusion(s): Orgasmic intensity differs between VAO and clitoral orgasms, independently of other confounding factors. This finding provides additional insight on the role of the clitourethrovaginal complex in female sexual function. Conflicts of Interest: None of the authors report any competing interests for the present study. Copyright © 2022

Impact of the COVID-19 Pandemic on the Female Sexual Function Index and Female Behavioral Changes: A Cross-Sectional Survey Study in Thailand.

Sexual health alterations are associated with disasters. Consequently, the COVID-19 pandemic may affect female sexual function. This study aimed to determine the COVID-19 pandemic effect on female sexual function and to know the risk of female sexual dysfunction. This online, cross-sectional, observational research was conducted during the pandemic period. A logistic regression model was used to investigate the associations between outcomes and potential risk factors. In total, 432 sexually active women participating in the region affected by the COVID-19 pandemic were analyzed. The overall findings of our study are that 60 percent of females were at risk for female sexual dysfunction. The average FSFI score was 21.27 ± 7.17. Comparing female sexual behavior before and during the COVID-19 pandemic reveals a significant decrease in the frequency of having sex per week, foreplay duration, and coital duration. In the multivariate analysis, the factors associated with the development of RFSD are age greater than 45 years (adjusted odds ratios (AOR) 15.09, 95% confidence interval (CI) 3.67-62.07), body mass index (BMI) greater than 25 (AOR 3.26, 95%CI 1.23-8.67), jobs as a healthcare provider (AOR 8.45, 95%CI 3.66-19.53), previous COVID-19 infection within the previous three months (AOR 36.81, 95%CI 10.93-123.98), and screened-positive anxiety (AOR 13.07, 95%CI 4.75-35.94). COVID-19 influences female sexual behavior and may increase the risk of sexual dysfunction in women. Concern for the effects of female sexual quality of life in high-risk individuals is essential.

Quality of life and sexual function analysis in a group of Italian postmenopausal women after COVID-19 vaccination.

AIM: The aim of the study was to evaluate the impact of SARS-CoV-2 vaccination on quality of life, psychological aspect and sexual life in a group of Italian postmenopausal women during the COVID-19 pandemic. METHODS: The study was a prospective, observational analysis of postmenopausal women before and after the COVID-19 vaccination. The population previously answered different questionnaires, such as the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale (FSDS), the 36-Item Short Form Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Twelve weeks after the end of the vaccine cycle, these women were invited to complete the same questionnaires by e-mail to evaluate if vaccination coverage could positively impact the quality of life of postmenopausal women. The Patient Impression of Global Improvement (PGI-I) after three months of treatment was also calculated. RESULTS: A total of 114 patients were reported. The median age was 60.96 (52-66) years. Mean sexual intercourses/month increased from 1.28 ± 1.23 to 4.21 ± 1.80 (p = 0.001). The FSFI increased (19.22 ± 3.31 vs 29.24 ± 4.21, p < 0.0001) and the FSDS decreased significantly (20.12 ± 5.23 vs 9.32 ± 5.55, p < 0.0001) 12 weeks after vaccination coverage. The SF-36 increased from 64.23 ± 11.76 to 82.21 ± 10.24 (p < .0001) and the HADS questionnaire improved significantly from 9.3 ± 2.73 to 5.1 ± 1.34 after the COVID-19 vaccine execution (p<.0001). CONCLUSIONS: The spread of COVID-19 vaccine coverage positively influenced sexual function, quality of life and psychological aspect in postmenopausal women.

Research trends and hotspots of COVID-19 impact on sexual function: A bibliometric analysis based on Web of Science.

Background: The outbreak of coronavirus disease 2019 (COVID-19) has brought indelible harms to the world and aroused great concern worldwide. This paper aims to analyze the impact of COVID-19 on sexual function using bibliometrics, and summarize research hotspots in this field. Methods: Relevant publications concerning the impact of COVID-19 on sexual function in the Web of Science collection database (WoSCC) between January 1, 2020 and March 12, 2022 were screened and analyzed by bibliometric analysis using the visualization software CiteSpace and VOSviewer. Results: Of the 1,054 publications screened, the United States (US) contributed the most (398/37.8%), followed by the United Kingdom (UK) (119/11.3%). Among all institutions, the University of Toronto in Canada enjoyed the largest number of publications (30), and Johns Hopkins University in the US enjoyed the highest frequency of citation (235). The journal INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH published the largest number of studies in this field (31), and the most-cited journal was LANCET. "Chow, Eric," "Ong, Jason J," and "Stephenson, Rob" tied for first place in publications (8), and "Fish, Jessica N." enjoyed the highest number of citations (99). Burstness analysis of references and keywords showed that the developing research trends in this field mainly focused on "sexual transmission" and "angiotensin converting-enzyme 2 (ACE2)" during the COVID-19 pandemic. Conclusion: The impact of COVID-19 on sexual function remains an urgent concern at present, and the management of sexual health during the pandemic needs to be further improved. More frequent and deeper cooperation between countries and institutions is required in future. Meanwhile, searching for more evidence on whether COVID-19 can achieve sexual transmission and the pathophysiological mechanisms underlying the impact of COVID-19 on sexual function remains a focus of research in the coming years.

Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis.

Implemented social distancing measures may have forestalled the spread of COVID-19, yet they suppressed the natural human need for contact. The aim of this systematic review was to explore the impact of the COVID-19 pandemic on adult sexual wellbeing and sexual behavior. An extensive search in Pubmed, Scopus, and PsycInfo databases based on PRISMA guidelines was conducted. After applying specific eligibility criteria, screening resulted in 38 studies. Results were drawn from 31,911 subjects and outlined the negative effect of the pandemic in sexual frequency, function, satisfaction, and the behavioral changes regarding masturbation and internet-based practices. Meta-analyses of the drawn data on 1,343 female, and 1,372 male subjects quantified the degree of sexual function change during the COVID-19 pandemic vs. prior the pandemic. A random effects model revealed the significant negative impact of the pandemic on female sexual function (SMD: 0.76, 95% CI:0.74 to 1.59), while no significant change was found for the males (SMD: 0.25, 95% Cl: -0.03 to 0.52). Significant heterogeneity was identified across included studies (p < 0.00001, I2 = 97%, I2 = 90% for females and males, respectively). As part of the global health, sexual wellbeing should be on the focus of clinicians and researchers.

SEXUALITY, FAMILY PLANNING and MENTAL HEALTH among REPRODUCTIVE-AGE WOMEN with RHEUMATIC DISEASE during the COVID-19 PANDEMIC

Background: Women with rheumatic disease are more likely to suffer from sexual dysfunction, infertility, depression, and anxiety. The pandemic may have affected these constraints. Objectives: To investigate the effect of the Covid-19 pandemic on sexuality, family planning and mental health in a sample of women with rheumatic disease. Methods: Women aged 18-50 with a rheumatic disease and women in an age-matched healthy control group received questionnaires featuring: 1) demographic information, sexual frequency, family planning;2) the Female Sexual Function Index (FSFI);3) the Depression, Anxiety and Stress Scale (DASS-21);and 4) the Coronavirus Anxiety Scale (CAS). Recruitment took place 3/21-12/21. Patients with rheumatic conditions were recruited at the Vienna University Clinic (AKH) and the control group through social media. Parameters were compared between the patients and the healthy control group, and with data on sexuality from women with rheumatic disease from 2019. Results: A preliminary analysis was conducted with 83 patients with rheumatic disease and 124 healthy controls. The rheumatic disease group exhibited lower levels of stress (6.46 vs. 8.36 p<0.01) and Coronavirus Anxiety (6.27 vs 7.50 p<0.01) than the control group and was less likely to report that the pandemic led to a reduction of their sexual frequency (p<0.01). The control group cited 'stress' frequently the decrease of sexual frequency. The FSFI analysis revealed that patients with rheumatic disease experienced higher levels of pain (p<0.001) during sex than the control group but were more satisfed with their relationships (p<0.05). In comparison to 58 patients with rheumatic conditions, whose data was collected in 2019, the 2021 cohort reported reduced FSFI values in the domains of desire (p<0.01), arousal (p<0.05), lubrication (p<0.05), and orgasms (p<0.01). Conclusion: Consistent with research on female sexuality during the pandemic among healthy women, we found that patients with rheumatic conditions reported lower FSFI values in 2021, in comparison to 2019. Our fnding that the pandemic had less impact on the patient group than a healthy control group, is consistent with research on MS and IBD patients, who showed surprising resilience in the face of the Covid-19 pandemic.

IMPACT OF THE COVID-19 PANDEMIC ON THE SEXUAL FUNCTION OF PATIENTS SEEKING FERTILITY CARE

Introduction: The COVID-19 pandemic and subsequent public health response resulted in unprecedented changes to society, including recommendations for social and physical distancing. Sexual dysfunction is best understood within a biopsychosocial framework, and it is reasonable to predict that biological, psychological, and social aspects of the COVID-19 pandemic may impact sexual function, particularly in a patient population actively planning pregnancy. Objective: The aim of this study was to understand the impact of the COVID19 pandemic - including COVID-19 infection, COVID-19 vaccination, and psychosocial conditions of the pandemic - on the sexual function of women receiving fertility care. Methods: Eligible patients aged 18 or older were identified using ICD codes related to female infertility and fertility testing and invited to complete an online survey regarding COVID-19 infection and vaccination status, fertility planning, and the impact of pandemic conditions on sexual function. Participants were recruited from a large academic-based fertility center and received care between April 2020 and April 2021. χ2 was used for between-group comparisons. Results: Of the 738 eligible patients, 197 participants completed the survey. Seventy-four (37.5%) participants had been pregnant within the past year and 168 (85.3%) participants had attempted to conceive in the past year. Forty-four (22.3%) participants reported prior COVID-19 infection, with 29 confirmed diagnoses and 15 suspected diagnoses. Further, 107 (54.2%) participants had been vaccinated against COVID-19, 35 (17.8%) were planning on being vaccinated, and 52 (26.4%) were not planning on being vaccinated. Participants declining vaccination cited concerns with health, fertility, pregnancy, breastfeeding, and a lack of vaccine safety data as common reasons for declining. Most (n = 180;91.4%) participants were sexually active at the time of survey, but only 25 (12.7%) reported their sex life was improved as a result of the pandemic;this did not differ in patients with or without a prior COVID-19 infection (15.9% vs. 11.8%, P=NS). These participants cited having more time with their partner, working from home, fewer outside stressors and social obligations, improved relationship dynamics and emotional bonding, and shared feelings about pandemic-related policies as reasons for improved sexual function. Of the 44 participants who had experienced COVID-19 infection, the majority (52.3%) expressed interest in returning to sexual activity within two weeks of infection. An additional 20.5% reported interest in sexual activity between two and four weeks after infection. Most (81.8%) stated that they were “not at all” or “not really” concerned about infecting their partner through intimacy or intercourse and 70.5% stated that their interest in sex was “not at all” or “not really” affected by their COVID-19 infection. Finally, 68.2% of participants reported that their ability to enjoy sex was “not at all” or “not really” affected by their COVID-19 infection. Conclusions: The majority of participants in this study did not experience improved sexual function during the pandemic, but those who did may offer insight into psychosocial and environmental factors that contribute to sexual function. The majority of participants who experienced COVID-19 infection did not report significant disruption to their sexual function as a result of their infection.