Association of urinary incontinence and sexual function in women.

OBJECTIVES: To investigate the association between urinary incontinence and female sexual function in a non-clinical population. METHODS: A self-administered questionnaire was distributed to 2159 female employees of two hospitals. RESULTS: Of the 883 sexually active participants, pure stress urinary incontinence was reported in 18.3%, pure urge urinary incontinence in 6.8%, mixed urinary incontinence in 15.1% and no urinary incontinence in 59.8%. The prevalence of female sexual difficulty, defined by the Female Sexual Function Index total score ≤ 26.55, was 52.0%, 56.1%, 54.3% and 42.2%, respectively (P < 0.05). After adjustment of age, menstrual status, length of marriage, having children and relationship with the partner, all types of urinary incontinence showed a significant association with female sexual difficulty with an odds ratio of 1.6-1.8. Taking into consideration the individual domains, pure urge urinary incontinence was a risk factor for decreased sexual lubrication and more sexual pain, and mixed urinary incontinence was a risk factor for less sexual satisfaction, whereas pure stress urinary incontinence was not related to a difficulty in individual domains. CONCLUSIONS: Stress urinary incontinence and urge urinary incontinence are associated with general impairment of female sexual function to a mild degree. Only urge urinary incontinence is related to sexual difficulty in specific domains including sexual lubrication and sexual pain.

Mechanisms of andrographolide-induced platelet apoptosis in human platelets: regulatory roles of the extrinsic apoptotic pathway.

Andrographolide, a novel nuclear factor-κB (NF-κB) inhibitor, is isolated from the leaves of Andrographis paniculata. Platelet activation is relevant to a variety of coronary heart diseases. Our recent studies revealed that andrographolide possesses potent antiplatelet activity by inhibition of the p38 MAPK/(●) HO-NF-κB-ERK2 cascade. Although platelets are anucleated cells, apoptotic machinery apparatus recently has been found to regulate platelet activation and limit platelet lifespan. Therefore, we further investigated the regulatory effects of andrographolide on platelet apoptotic events. In this study, apoptotic signaling events for caspase-3, -8, and Bid were time (10-60 min)- and dose (25-100 µΜ)-dependently activated by andrographolide in human platelets. Andrographolide could also disrupt mitrochondrial membrane potential. In addition, caspase-8 inhibitor (z-IETD-fmk, 50 µΜ) was found to reverse andrographolide-induced caspase-8 activation, whereas the antagonistic anti-Fas receptor (ZB4, 500 ng/mL) and anti-tumor necrosis factor-R1 (H398, 10 µg/mL) monoclonal antibodies did not. In conclusion, this study for the first time demonstrated that andrographolide might limit platelet lifespan by initiating the caspase-8-dependent extrinsic apoptotic pathway, in spite of no direct evidence that death receptors are involved in this process proved. Overall, the various medicinal properties of andrographolide suggest its potential value in treating patients with thromboembolic disorders.

Is female sexual function related to the male partners' erectile function?

INTRODUCTION: There are limited data concerning the relationship between the sexual functioning of each partner in a heterosexual couple. AIM: This cross-sectional study was to investigate the association between female sexual function and the male partners' erectile function. METHODS: Two self-administered questionnaires were used, one distributed to 2,159 female employees of two hospitals in Southern Taiwan and the other to their male partners, if available, to assess sexual function in each partner of the couple. OUTCOME MEASURE: Female sexual function and male erectile function were assessed by the Female Sexual Function Index (FSFI) and by the International Index of Erectile Function (IIEF), respectively. RESULTS: Among the 1,580 female and 779 male respondents, 632 sexually active couples were eligible for the analysis with mean ages of 36.9 years (range 21-67) and 39.5 years (range 18-80) for the women and men, respectively. After adjustment for female age group, nearly all the FSFI and IIEF domain scores correlated significantly to a slight to moderate degree. On the basis of the FSFI and IIEF scores, 42.9% (255/594) of the women reported sexual difficulty, and 15.0% (96/632) of the men reported mild to moderate erectile dysfunction (ED). After adjustment for female age group, the female partners of men with ED had significantly lower total and domain scores of the FSFI than those of men without ED, with effect sizes of η(p)(2) = 0.02-0.08. After further adjustment for other risk factors, ED of the male partner was still a significant risk factor for female sexual difficulty as well as for sexual difficulty in the aspects of arousal, orgasm, sexual satisfaction, and sexual pain (odds ratio = 2.5-3.3). CONCLUSIONS: Significant correlations between female sexual functioning and male erectile function were identified.

Risk factors for individual domains of female sexual function.

INTRODUCTION: Female sexual function contains four major subtypes of desire, arousal, orgasm, and pain. Few studies used validated instruments to determine the dysfunction in these areas and assess their risk factors. AIM: To assess the prevalence of and risk factors for individual components of sexual difficulty in women. METHODS: A self-administered questionnaire containing the Female Sexual Function Index (FSFI) was given to 2,159 woman employees of two hospitals to assess their sexual function and its correlates. MAIN OUTCOME MEASURES: The associations between female sexual difficulty in individual domains defined by the FSFI domain scores and potential risk factors assessed by simple questions. RESULTS: Among the 1,580 respondents, 930 women's data were eligible for analysis with a mean age of 36.1 years (range 20-67). Of them, 43.8% had sexual difficulty in one or more domains, including low desire in 31.3%; low arousal, 18.2%; low lubrication, 4.8%; low orgasmic function, 10.4%; low satisfaction, 7.3%; and sexual pain, 10.5%. Compared with the younger women (20-49 years), the oldest age group (50-67 years) had a significantly higher prevalence in low desire, low arousal, and low lubrication, but not in the other domains. Based on multivariate logistic regression analyses, poor relationship with the partner and perception of partner's sexual dysfunction were major risk factors for low desire, low arousal, low orgasmic function, and low satisfaction. Age and urge urinary incontinence were associated with low lubrication and sexual pain. Most comorbidities were not related to these difficulties, except diabetes being related to low desire. CONCLUSIONS: Relationship factors had substantial impact on female sexual function in desire, arousal, orgasm, and satisfaction. On the other hand, women's lubrication problem and sexual pain were related predominantly with biological factors. These are initial results and future research is needed to confirm them.