The effect of duloxetine on female sexual functions in the treatment of stress incontinence.

OBJECTIVES: Stress urinary incontinence (SUI) is defined as urinary incontinence that occurs with coughing, sneezing, and physical exercise. It is frequently observed in women after middle age and has a negative impact on their sexual function. Duloxetine as one of the Serotonin-noradrenaline reuptake inhibitors (SNRIs) is commonly used in the non-surgical treatment of SUI. The aim of our study is to investigate the effect of duloxetine, which is used in the treatment of SUI, on sexual functions in female patients. METHODS: The study included 40 sexually active patients who received duloxetine 40 mg twice a day for the treatment of SUI. All patients had female sexual function index (FSFI), Beck's depression inventory (BDI), and incontinence quality of life score (I-QOL) applied before and 2 months after starting duloxetine treatment. RESULTS: FSFI total score significantly increased from 19.9 to 25.7 (p < 0.001). In addition, significant improvement was observed in all sub-parameters of FSFI, including arousal, lubrication, orgasm, satisfaction, and pain/discomfort (p < 0.001, for each FSFI subtotal score). BDI significantly decreased from 4.5 to 1.5 (p < 0.001). I-QOL score significantly increased from 57.6 to 92.7 after the duloxetine treatment. CONCLUSIONS: Although SNRIs carry a high risk of sexual dysfunction, duloxetine may have an indirect positive effect on female sexual activity, both through its stress incontinence treatment and its antidepressant effect. In our study, Duloxetine, one of the treatment options for stress urinary incontinence and an SNRI, has a positive effect on stress urinary incontinence, mental health, and sexual activity in patients with SUI.

The effect of renal transplantation for end-stage renal disease on female sexual function and depression.

INTRODUCTION: Studies have suggested that women with end-stage renal disease (ESRD) had higher risk of sexual dysfunction than healthy women. AIMS: To prospectively determine the effect of renal transplantation for ESRD on female sexual function and depression. METHODS: During a 5-year period, the study included 21 sexually active women who underwent renal transplantation for ESRD at a single university hospital. After obtaining demographic characteristics, female sexual function was evaluated with a detailed 19-item questionnaire (The Female Sexual Function Index, FSFI), and depression was assessed using Beck Depression Inventory (BDI) scale. MAIN OUTCOME MEASURES: In all women, FSFI and BDI scores were compared before and after the renal transplantation surgery. RESULTS: The mean age of the women was 35.04 ± 9.6 years, and mean follow-up duration after renal transplantation was 27.5 ± 20.4 months. Mean total sexual function score increased from 17.57 ± 7.07 to 25.3 ± 3.28, revealing significant difference (P = 0.001). Compared with preoperative period, sexual function domains including sexual desire (P = 0.001), arousal (P = 0.001), lubrication (P = 0.003), orgasm (P = 0.001), satisfaction (P = 0.001), and pain (P = 0.02) significantly improved after renal transplantation. Mean BDI score significantly decreased from 17.91 ± 8.56 to 3 ± 4.17 after renal transplantation (P = 0.001). CONCLUSIONS: Successful renal transplantation may improve female sexual functions and depression. Therefore, life quality increases as sexual functions and depression improve after the renal transplantation surgery.

Sexual dysfunction and associated risk factors in women with end-stage renal disease.

INTRODUCTION: End-stage renal disease (ESRD) is a serious illness which has severe negative effects on patients' lives and quality of life. AIMS: To prospectively compare sexual functions between the women with ESRD and healthy women, and also to investigate risk factors that may cause sexual dysfunction in women with ESRD. METHODS: The study included 249 women, and the women were divided into two groups: 131 women with ESRD and 118 healthy women as a control group. After obtaining demographic characteristics, sexual function was evaluated with a detailed 19-item questionnaire (The Female Sexual Function Index [FSFI]) assessing sexual desire, arousal, lubrication, orgasm, satisfaction, and pain during sexual intercourse. MAIN OUTCOME MEASURES: The FSFI scores were compared between the two groups, and risk factors that might cause sexual dysfunction were also investigated in the women with ESRD. Results. The mean FSFI total score was significantly lower in the ESRD group (15.9 +/- 10.4) than in the control group (22.2 +/- 6.8) (P = 0.001). The women with ESRD had also significantly lower mean score of sexual desire (P = 0.006), arousal (P = 0.001), lubrication (P = 0.001), orgasm (P = 0.001), satisfaction (P = 0.001), and pain (P = 0.024) than in the control group. To investigate risk factors for sexual dysfunction in the ESRD group, the women having hemodialysis, compared to the women having peritoneal dialysis, had a 5.23 times greater risk of developing sexual dysfunction (P = 0.001). CONCLUSIONS: This study shows that women with ESRD have higher risk of sexual dysfunction than healthy women. Thus, women with ESRD should be consulted for sexual dysfunction to improve the quality of life.