Pelvic Floor Muscle Training Effect in Sexual Function in Postmenopausal Women: A Randomized Controlled Trial.

BACKGROUND: The prevalence of sexual dysfunction is high in postmenopausal women and pelvic floor muscle training (PFMT) could improve sexual function during this period. AIM: To assess the effect of a PFMT protocol on sexual function in postmenopausal women and to investigate the effect of this protocol on pelvic floor muscle function. METHODS: This is an assessor blinded randomized controlled trial including 77 postmenopausal women. The study was registered in ReBEC Trial: RBR-3s3ff7. The intervention group (n = 40) received an intensive supervised PFMT protocol during 12 weeks and the control group (n = 37) received no intervention. OUTCOMES: The primary outcome of the study was assessed by the Female Sexual Function Index (FSFI) questionnaire and the secondary outcome was the evaluation of pelvic floor muscle function performed by digital palpation using the modified Oxford scale at baseline and after 12 weeks. RESULTS: No difference between groups was found in the FSFI domains and total score at baseline and in the second evaluation after 12 weeks. However, after 12 weeks, a higher percentage of women without sexual dysfunction was found in the intervention group (95% CI = 27.97-72.03) when compared to the control group (95% CI = 7.13-92.87). No difference was found between groups in relation to the pelvic floor muscle function at the baseline (P = .2) and after 12 weeks (P = .06). CLINICAL IMPLICATIONS: PFMT is a conservative intervention that can lead women to have less sexual dysfunction. STRENGTHS & LIMITATIONS: The protocol provided a reduced number of women with sexual dysfunction, the strength of this research is the study design and the limitation is to have used only one tool to assess sexual function although it is a validated questionnaire. CONCLUSION: PFMT decreases sexual dysfunction in postmenopausal women. MM Franco, CC Pena, LM de Freitas, et al. Pelvic Floor Muscle Training Effect in Sexual Function in Postmenopausal Women: A Randomized Controlled Trial. J Sex Med 2021;18:1236-1244.

Comparison of Sexual Dysfunction in Women Who Were or Were Not Victims of Sexual Violence.

The victims of sexual violence may develop FSD. This retrospective study examined the characteristics of women victims of sexual abuse who had FSD who attended a tertiary hospital from 2004 to 2017. Patients were divided in two groups: women who were victims of sexual violence and women who were not victims (controls). One thousand and ten women (60.4%) presented with FSD and 610 of them were eligible for inclusion, 134 (21.97%) reported they were victims of sexual violence, and the abuser was mostly someone close to the victim (92.31%). Depression was more prevalent in the women who were victims (32.1% vs. 18.3%; p<0.05), 74.0% vs. 59.8% had hypoactive sexual desire disorder (HSDD) (p<0.05), 20.3% of victims vs. 7.19% of controls (p<0.05) had primary anorgasmia, and 51.15% of the victims and 39.61% of controls reported anorgasmia. The victims reported a lower sex drive (39.6% vs. 52.3%), and reduced arousal (48.8% vs. 61.3%; all p<0.05). More of the victims than controls reported that their partners had engaged in an extramarital relationship (19.0% vs. 9.25%, p<0.05).

Determinants of Female Sexual Function in Breastfeeding Women.

Knowledge about the determinants of female sexual function in breastfeeding women is limited. A total of 355 breastfeeding women completed the Female Sexual Function Index (FSFI) and the Qol-8 quality of life questionnaire. FSFI scores decreased in the first six months of breast feeding. There was a positive relationship between FSFI scores and the importance of sex, level of communication, income, quality of life, and receiving brief sexual counseling.

Age at Time of Initial Sexual Intercourse and Health of Adolescent Girls.

Adolescence is characterized by marked changes in the body, psychology, and sexual behavior due to increasing production of hormones. In this review we aimed to assess the effect of age at the time of first sexual intercourse (sexarche) on the health of adolescent girls, and identify factors that might protect against early initiation of sexual relations in girls. The PubMed, Lilacs, and Google Scholar databases were searched for clinical trials, comparative studies, case-control studies, cross-sectional studies, cohort studies, multicenter studies, observational studies, meta-analyses, and systematic reviews published up to December 2014 on this theme. The search terms were: "sexual debut," "coitarche," "sexarche," and "young people," "adolescent," "unplanned pregnancy," "adolescent contraception," and "STDs." Data were extracted from 28 studies and 41 references were used to introduce the theme and to support the discussion. Sexarche has been occurring in increasingly younger girls. A young age at sexarche can lead to subsequent risky sexual behavior. Girls who have sexarche when they are 14 years old or younger are less likely to use contraception on this occasion, take more time before they start using contraception in subsequent sexual relations, are more likely to have several sex partners, have a higher risk for depression, have lower self-esteem and more episodes of repentance, and have a higher risk for a sexually transmitted disease and cervical cancer. Girls with low educational, socioeconomic, and cultural status, little parental monitoring, parental separation, and absence of religiosity tend to experience sexarche at a younger age. Adolescent girls who postpone sexarche until they are 16 years old are physically and psychologically healthier than those who have sexarche at a younger age. This suggests that providing adolescent girls with appropriate education about sexual relations might reduce the negative effect of sexual relations at a young age.

Gonadotropin and Estradiol Levels after Leuprolide Stimulation Tests in Brazilian Girls with Precocious Puberty.

STUDY OBJECTIVE: To determine the best cutoff value on the leuprolide stimulation test for the diagnosis of central precocious puberty (CPP) in a Brazilian population. DESIGN, SETTING, AND PARTICIPANTS: This observational study included 60 girls with CPP, as shown on the basis of serum concentrations of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) before and 3 hours after subcutaneous administration of 500 µg leuprolide acetate and by measuring serum estradiol concentrations 24 hours later. Six months later, each subject was clinically evaluated to determine whether she had experienced progressive or nonprogressive puberty. MAIN OUTCOME MEASURES: Analyzing the best cutoff for LH after subcutaneous administration of 500 µg leuprolide acetate. RESULTS: The best cutoff was a 3-hour LH level of greater than 4.0 mIU/mL, providing the highest sensitivity (73%) and specificity (83.1%), whereas a 3-hour LH level greater than 8.4 mIU/mL had a specificity of 100%. A 24-hour E2 concentration greater than 52.9 pg/mL had a sensitivity of 68% and a specificity of 74%. There was no association between pubertal development and disease progression. Signs such as thelarche and pubarche did not determine the evolution of the disease (P = .17). Clinical condition was associated with bone age/chronological age (P = .01), basal LH (P < .01), 3-hour LH (P = .02), baseline LH/FSH indices (P < .01) and after 3 hours (P < .01), and E2 at 24 hours (P = .02). CONCLUSION: The optimal parameter indicating hypothalamic-pituitary-gonadal axis activation in our sample was a 3-hour LH level greater than 4.0 mIU/mL. A diagnosis of CPP, however, should be based on a set of criteria and not on an isolated measurement, because typical laboratory findings associated with CPP may not be present in all patients.

Cytology for the detection of early recurrence of gynecologic cancer in the vaginal vault.

OBJECTIVE: The real benefit of follow-up cervical cytology in women treated for gynecological cancer is unclear. This study was designed to assess the rate of success of cytological examinations in the detection of early vaginal recurrence of gynecological cancer in women found by other methods to have vaginal recurrence of cervical and endometrial cancer. DATA SOURCES: Records of cytological examinations. STUDY SELECTION: Thirty-three women treated for early and invasive cervical and endometrial cancer with recurrence in the vaginal vault were retrospectively analyzed. DATA EXTRACTION: Records from 1979 to 2010. DATA SYNTHESIS: Sixteen women (48.5%) had symptomatic vaginal recurrence associated with distant metastases, whereas 17 (51.5%) had vaginal recurrence only. Cytology was negative in 12 women (36.4%) with both symptomatic and asymptomatic recurrence and positive in the other 21 (63.6%). In 9 of these 21 women (42.9%), the disease was limited to the vaginal vault, whereas the remaining 12 (57.1%) presented with vaginal lesions associated with distant metastases. Cytology was positive in 9 of the 17 (52.9%) women whose recurrence was limited to the vaginal vault and negative in 8 (47.1%). CONCLUSION: Vaginal cytology yielded false-negative results in almost half of the women with vaginal recurrence of gynecological cancer. Patents of methods used for early diagnosis and detection of immortalization of cervical cancer are also reviewed in this article.

Current research on how infertility affects the sexuality of men and women.

OBJECTIVE: To assess data published from 2000 to 2010 on the effect of infertility on the sexual function of men and women. DATA SOURCES: The PubMed, Lilacs and Embase databases were searched for scientific articles assessing the sexual response of couples during infertility treatment. STUDY SELECTION: Studies selected for this review were published in English and conducted in human beings; articles included meta-analyses and cross-sectional or cohort studies that used objective measurement tools to quantitatively assess the data. DATA EXTRACTION: Seven studies met the inclusion criteria for this review. DATA SYNTHESIS: Infertility is a major risk factor for sexual problems in both men and women. CONCLUSION: Infertile couples are at higher risk of sexual dysfunction than fertile couples. We also describe several recent patents.