Effects of Transcranial Direct Current Stimulation and Pelvic Floor Muscle Training in Women: protocol for a controlled, randomized, double-blind clinical trial / Efectos de la estimulación transcraneal por corriente directa y del entrenamiento muscular del suelo pélvico en mujeres: protocolo de un ensayo clínico controlado, aleatorizado y doble ciego / Efeitos da estimulação transcraniana por corrente contínua e treinamento muscular do assoalho pélvico em mulheres: protocolo para um ensaio clínico controlado, randomizado e duplo-cego

ABSTRACT Pelvic floor muscle weakness can lead to urinary incontinence, pelvic organ prolapse, and sexual dysfunction. Although it can be minimized by pelvic floor muscle training (PFMT), its effects are not lasting. Therefore, using combination therapy seems promising. This study aims to evaluate the effect of transcranial direct current stimulation (tDCS) combined with PFMT on intravaginal pressure, pelvic floor muscle strength (PFMS), sexual function (SF), and quality of life (QoL) in healthy women. A total of 32 women, aged from 18 to 45 years, will undergo PFMT (with perineal contractions and relaxation) with the aid of pressure biofeedback associated with active tDCS or sham tDCS. Sessions will last 20 minutes, three times per week, for four weeks, totaling 12 sessions. During the protocol, participants will be instructed to also perform the home-based PFMT daily. The tDCS anodal electrode will be positioned over the supplementary motor area of the dominant cortical hemisphere, whereas the cathodal will be over the contralateral supraorbital region, with a 2mA intensity for 20 minutes. Intravaginal pressure (pressure gauge), PFM strength (measured by digital palpation and the PERFECT scheme), FSFI (Female Sexual Function Index), and QoL (SF-36 questionnaire) will be evaluated before and after the 12 sessions and after a 30-day follow-up.

RESUMEN La debilidad de la musculatura del suelo pélvico puede provocar incontinencia urinaria, prolapso de órganos pélvicos y disfunción sexual, y puede minimizarse mediante el entrenamiento de la musculatura del suelo pélvico (EMSP). Sin embargo, este efecto no es duradero. En este contexto, una terapia combinada puede ser prometedora para mejorar la situación. Este estudio tiene por objetivo evaluar el efecto de la estimulación transcraneal por corriente directa (ETCC) combinada con EMSP sobre la presión intravaginal, la fuerza muscular del suelo pélvico (FMSP), la función sexual (FS) y la calidad de vida (CV) en mujeres sanas. Participarán 32 mujeres, de entre 18 y 45 años, que se someterán a EMSP (contracciones y relajación del perineo) y a Biofeedback asociado a ETCC activa o ETCC sham durante 20 minutos, tres veces por semana, durante 4 semanas, con un total de 12 sesiones. Durante el protocolo, las participantes también se someterán diariamente a EMSP en casa. El electrodo anodal de la ETCC se colocará sobre el área motora suplementaria del hemisferio cortical dominante, y el electrodo catodal sobre la región supraorbital contralateral, a una intensidad de 2 mA, durante 20 minutos. Se evaluarán la presión intravaginal (manómetro), la FMSP (palpación digital, esquema Perfect), la FS (Índice de Función Sexual Femenina) y la CV (cuestionario SF-36) antes y después de las 12 sesiones, así como tras un seguimiento de 30 días.

RESUMO A fraqueza muscular do assoalho pélvico pode gerar incontinência urinária, prolapso de órgãos pélvicos e disfunção sexual, e pode ser minimizada pelo treinamento muscular do assoalho pélvico (TMAP). No entanto, este efeito não é duradouro. Assim, terapia combinada parece ser promissora para a melhora deste quadro. Dessa forma, objetiva-se avaliar o efeito da estimulação transcraniana por corrente contínua (ETCC), combinada ao TMAP, sobre a pressão intravaginal, força muscular do assoalho pélvico (FMAP), função sexual (FS) e qualidade de vida (QV) em mulheres saudáveis. Serão 32 mulheres, entre 18 e 45 anos, que realizaram TMAP (contrações e relaxamento do períneo) e Biofeedback associados a ETCC ativa ou ETCC sham por 20 minutos, três vezes por semana, por 4 semanas, totalizando 12 sessões. Durante o protocolo, as participantes também realizarão diariamente, em domicílio, o TMAP. O eletrodo anodal da ETCC será posicionado sobre a área motora suplementar do hemisfério cortical dominante, e o catodal sobre a região supraorbital contralateral, com intensidade de 2mA, por 20 minutos. A pressão intravaginal (manômetro de pressão), FMAP (palpação digital, esquema Perfect), FS (Índice de Função Sexual Feminina) e QV (questionário SF-36) foram avaliadas antes e depois das 12 sessões, bem como após acompanhamento de 30 dias.

Obesity and female sexual dysfunctions: A systematic review of prevalence with meta-analysis.

Obesity represents a major global health challenge. Female sexual dysfunctions have a negative impact on quality of life and overall health balance. A higher rate of female sexual dysfunctions in obese women has been suggested. This systematic review summarized the literature on female sexual dysfunction prevalence in obese women. The review was registered (Open Science Framework OSF.IO/7CG95) and a literature search without language restrictions was conducted in PubMed, Embase and Web of Science, from January 1990 to December 2021. Cross-sectional and intervention studies were included, the latter if they provided female sexual dysfunction rate data in obese women prior to the intervention. For inclusion, studies should have used the female sexual function index or its simplified version. Study quality was assessed to evaluate if female sexual function index was properly applied using six items. Rates of female sexual dysfunctions examining for differences between obese vs class III obese and high vs low quality subgroups were summarized. Random effects meta-analysis was performed, calculating 95% confidence intervals (CI) and examining heterogeneity with I2 statistic. Publication bias was evaluated with funnel plot. There were 15 relevant studies (1720 women participants in total with 153 obese and 1567 class III obese women). Of these, 8 (53.3%) studies complied with >4 quality items. Overall prevalence of female sexual dysfunctions was 62% (95% CI 55-68%; I2 85.5%). Among obese women the prevalence was 69% (95% CI 55-80%; I2 73.8%) vs 59% (95% CI 52-66%; I2 87.5%) among those class III obese (subgroup difference p=0.15). Among high quality studies the prevalence was 54% (95% CI 50-60%; I2 46.8%) vs 72% (95% CI 61-81%; I2 88.0%) among low quality studies (subgroup difference p=0.002). There was no funnel asymmetry. We interpreted that the rate of sexual dysfunctions is high in obese and class III obese women. Obesity should be regarded as a risk factor for female sexual dysfunctions.

Comparison of early period sexual function parameters between surgical repair and conservative treatment after penile fracture / Comparación de los parámetros de función sexual en el período temprano entre la reparación quirúrgica y el tratamiento conservador después de una fractura de pene

Introduction and objectives: Comparison of early period sexual function parameters in patients who had surgical repair and conservative follow-up after penile fracture and the evaluation of surgical intervention time on these parameters were planned in this study. Materials and methods: Total of 26 patients who were treated for penile fracture were evaluated. 19 patients had surgical repair and 7 patients had conservative treatment.Sexual function and erectile dysfunction (ED) degree of the patients before penile fracture and in the 12th week after fracture were evaluated with 5-question International Index of Erectile Function (IIEF-5) questionnaire, Erection Hardness Score (EHS), Sexual Encounter Profile(SEP) 2 and SEP 3. Parameters showing sexual function before and after the fracture were compared. Results: In both groups, a significant change was detected in IIEF-5 score, EHS, SEP-2 and SEP-3 parameters of the patients measured after penile fracture compared to the values before the fracture (all parameters, p<0.05). No difference was detected in the parameters measured before and after the fracture among surgical repair and conservative treatment groups (all parameters p>0.05). Mean time passing until the surgery after fracture was measured as 9.6±6.85h in 19 patients who had surgery. Conclusion: A difference wasn’t detected in sexual parameters in conservative treatment and surgical repair groups in this study. As a significant decrease was observed in sexual function parameters even in conservative treatment cases without sudden detumescence and tunica albuginea rupturing, we think that quick surgical exploration would be useful in cases considered to have penile fracture. (AU)

Introducción y objetivos: En este estudio se planificó la comparación de los parámetros de función sexual en el período temprano en pacientes sometidos a reparación quirúrgica y seguimiento conservador después de una fractura de pene y la evaluación del tiempo de intervención quirúrgica sobre estos parámetros. Materiales y métodos: Se evaluaron un total de 26 pacientes que fueron tratados por fractura de pene: 19 fueron sometidos a reparación quirúrgica y 7 tuvieron un seguimiento conservador. La función sexual y el grado de disfunción eréctil de los pacientes antes de la fractura de pene y en la semana 12 después de la fractura se evaluaron con el cuestionario International Index of Erectile Function de 5 preguntas (IIEF-5), el Erection Hardness Score (EHS), y el Sexual Encounter Profile (SEP) 2 y SEP 3. Se compararon los parámetros que muestran la función sexual antes y después de la fractura. Resultados: En ambos grupos se detectó un cambio significativo en la puntuación IIEF-5 y los parámetros EHS, SEP 2 y SEP 3 de los pacientes medidos después de la fractura de pene en comparación con los valores antes de la fractura (todos los parámetros, p<0,05). No se detectaron diferencias en los parámetros medidos antes y después de la fractura entre los grupos de reparación quirúrgica y tratamiento conservador (todos los parámetros p>0,05). El tiempo medio transcurrido hasta la cirugía después de la fractura se midió como 9,6±6,85h en los 19 pacientes intervenidos. Conclusión: No se detectaron diferencias en los parámetros sexuales entre los grupos de observancia conservadora y reparación quirúrgica en este estudio. Como se observó una disminución significativa de los parámetros de función sexual incluso en casos de seguimiento conservador sin detumescencia súbita y desgarro de la túnica albugínea, pensamos que la exploración quirúrgica rápida sería útil en los casos en los que se considere que tienen fractura de pene. (AU)

Beneficial effects of Pilates exercise on female sexual dysfunction: A prospective pilot study / Efectos beneficiosos del ejercicio de Pilates en la disfunción sexual femenina: un estudio piloto prospectivo

Objective: Female sexual dysfunction (FSD) is a significant public health issue, and it has a high global prevalence. Few effective treatment options are available for the treatment of FSD. We conducted a prospective clinical pilot study to investigate the beneficial effects of Pilates exercise on sexual function in women with FSD. Methods: Women aged between 20 and 50 years and who had regular menstrual cycles and sexual relationships and participating Pilates exercise program were asked to complete Beck Depression Inventory (BDI) and Female Sexual Function Index (FSFI) questionnaires before starting the Pilates exercise program. If the total FSFI score was less than 26.55, which is the cut-off for FSD, the subject was invited to participate in the study. Primary endpoints were changes in total and individual domain scores on the FSFI and BDI. Results: A total of 36 premenopausal women were included in the study. After a 12-week Pilates program, all domains of the FSFI were significantly improved, with mean±SD total FSFI scores increasing from 12.0±4.9 to 29.3±3.4 (P<0.0001). BDI scores were significantly decreased from 25.1±14.3 to 1.6±3.7 (P<0.0001) after the exercise program. Conclusions: This pilot study showed that Pilates exercise could improve sexual functions in women with FSD. Pilates may facilitate the treatment of sexual dysfunction in women. (AU)

Objetivo: La disfunción sexual femenina (DSF) es un importante problema de salud pública, y tiene una alta prevalencia mundial. Se dispone de pocas opciones terapéuticas eficaces para el tratamiento de la DSF. Realizamos un estudio piloto clínico prospectivo para investigar los efectos beneficiosos del ejercicio de Pilates en la función sexual de las mujeres con DSF. Métodos: A las mujeres de entre 20 y 50 años que tenían ciclos menstruales y relaciones sexuales regulares, y que participaban en el programa de ejercicios de Pilates se les pidió que completaran los cuestionarios del Inventario de Depresión de Beck (BDI) y del índice de función sexual femenina (FSFI) antes de comenzar el programa de ejercicios de Pilates. Si la puntuación total del FSFI era inferior a 26,55, que es el punto de corte para la FSD, se invitaba al sujeto a participar en el estudio. Los puntos finales primarios fueron los cambios en las puntuaciones totales y de dominio individual en el FSFI y el BDI. Resultados: Un total de 36 mujeres premenopáusicas fueron incluidas en el estudio. Después de un programa de Pilates de 12 semanas, todos los dominios del FSFI mejoraron significativamente, con puntuaciones medias±SD del FSFI total que aumentaron de 12,0±4,9 a 29,3±3,4 (p<0,0001). Las puntuaciones del BDI disminuyeron significativamente de 25,1±14,3 a 1,6±3,7 (p<0,0001) después del programa de ejercicios. Conclusiones: Este estudio piloto mostró que el ejercicio de Pilates podría mejorar las funciones sexuales en las mujeres con FSD. El Pilates puede facilitar el tratamiento de la disfunción sexual en las mujeres. (AU)

Beneficial effects of Pilates exercise on female sexual dysfunction: A prospective pilot study.

OBJECTIVE: Female sexual dysfunction (FSD) is a significant public health issue, and it has a high global prevalence. Few effective treatment options are available for the treatment of FSD. We conducted a prospective clinical pilot study to investigate the beneficial effects of Pilates exercise on sexual function in women with FSD. METHODS: Women aged between 20 and 50 years and who had regular menstrual cycles and sexual relationships and participating Pilates exercise program were asked to complete Beck Depression Inventory (BDI) and Female Sexual Function Index (FSFI) questionnaires before starting the Pilates exercise program. If the total FSFI score was less than 26.55, which is the cut-off for FSD, the subject was invited to participate in the study. Primary endpoints were changes in total and individual domain scores on the FSFI and BDI. RESULTS: A total of 36 premenopausal women were included in the study. After a 12-week Pilates program, all domains of the FSFI were significantly improved, with mean±SD total FSFI scores increasing from 12.0±4.9 to 29.3±3.4 (P<0.0001). BDI scores were significantly decreased from 25.1±14.3 to 1.6±3.7 (P<0.0001) after the exercise program. CONCLUSIONS: This pilot study showed that Pilates exercise could improve sexual functions in women with FSD. Pilates may facilitate the treatment of sexual dysfunction in women.

Comparison of early period sexual function parameters between surgical repair and conservative treatment after penile fracture.

INTRODUCTION AND OBJECTIVES: Comparison of early period sexual function parameters in patients who had surgical repair and conservative follow-up after penile fracture and the evaluation of surgical intervention time on these parameters were planned in this study. MATERIALS AND METHODS: Total of 26 patients who were treated for penile fracture were evaluated. 19 patients had surgical repair and 7 patients had conservative treatment. Sexual function and erectile dysfunction (ED) degree of the patients before penile fracture and in the 12th week after fracture were evaluated with 5-question International Index of Erectile Function (IIEF-5) questionnaire, Erection Hardness Score (EHS), Sexual Encounter Profile(SEP) 2 and SEP 3. Parameters showing sexual function before and after the fracture were compared. RESULTS: In both groups, a significant change was detected in IIEF-5 score, EHS, SEP-2 and SEP-3 parameters of the patients measured after penile fracture compared to the values before the fracture (all parameters, p<0.05). No difference was detected in the parameters measured before and after the fracture among surgical repair and conservative treatment groups (all parameters p>0.05). Mean time passing until the surgery after fracture was measured as 9.6±6.85h in 19 patients who had surgery. CONCLUSION: A difference wasn't detected in sexual parameters in conservative treatment and surgical repair groups in this study. As a significant decrease was observed in sexual function parameters even in conservative treatment cases without sudden detumescence and tunica albuginea rupturing, we think that quick surgical exploration would be useful in cases considered to have penile fracture.

La función sexual y su relación con los factores psicológicos en las mujeres con el síndrome de ovario poliquístico / Sexual function and its relationship to psychological factors in women with polycystic ovary syndrome

Introducción: El síndrome de ovario poliquístico tiene un notable impacto en la vida de las personas que lo padecen, siendo las áreas psicológica y sexual frecuentemente afectadas. Objetivos: Realizar una revisión bibliográfica sobre la función sexual y su relación con factores psicológicos en mujeres con síndrome de ovario poliquístico. Métodos: Se revisaron las bases de datos Google Scholar, Pubmed Central y SciELO Regional por intermedio del buscador web de Google. Algunos de los aspectos tratados en el artículo fueron los factores psicológicos, las hormonas sexuales y la función sexual, la imagen corporal y el síndrome de ovario poliquístico, y la función sexual y el síndrome de ovario poliquístico. Conclusiones: Los aspectos más estudiados del síndrome de ovario poliquístico han estado relacionados con la conceptualización y fisiopatología de la enfermedad, y las manifestaciones reproductivas y metabólicas. Otros aspectos igualmente importantes como los psicosociales y sexuales han sido muy escasamente abordados y los datos disponibles son contradictorios. Se requieren investigaciones de corte psicosocial para profundizar en las particularidades de la vida psicoemocional y sexual de esta población. Aún existe un campo novedoso poco explorado y permanecen vacíos de información en torno a la sexualidad que por su impacto influyen en el bienestar psicológico y la calidad de vida(AU)

Introduction: Polycystic ovary syndrome has a notable impact on the lives of those who suffer from it, with the psychological and sexual areas frequently affected. Objective: To carry out a literature review on sexual function and its relationship with psychological factors in women with polycystic ovary syndrome. Methods: Google Scholar, Pubmed Central and SciELO Regional databases were reviewed through the Google web search engine. Some of the aspects covered in the article were psychological factors, sex hormones and sexual function, body image and polycystic ovary syndrome, and sexual function and polycystic ovary syndrome. Conclusions: The reviewed literature allows affirming that in the Cuban and international context the most studied aspects of polycystic ovary syndrome have been related to the conceptualization and physiopathology of the disease, and its reproductive and metabolic manifestations. Other equally important aspects such as psychosocial and sexual aspects have been very scarcely broached and the available information is contradictory. Psychosocial research is needed to delve deeper into the particularities of the psychoemotional and sexual life of this population. There is still a novel field that has not been sufficiently explored and there are still gaps in the information on sexuality that, due to their impact, influence the psychological well-being and the patients' quality of life(AU)

Sexual function and depressive symptoms in men with hypoprolactinaemia secondary to overtreatment of prolactin excess: A pilot study.

BACKGROUND: Low prolactin levels have been found to impair libido and arousal, as well as to reduce wellbeing in young women. OBJECTIVE: The aim of this study was to investigate whether drug-induced hypoprolactinaemia affects male sexual function and depressive symptoms. METHODS: The study population consisted of three groups of young and middle-aged men. Two groups were treated with dopamine agonists because of previous hyperprolactinaemia but differed in current prolactin levels, which were <3ng/ml (n=12; group 1) or within the reference range (3-20ng/ml) (n=20; group 2). The control group (group 3) included 24 dopamine agonist-naïve normoprolactinaemic men. During the study, doses of dopaminergic agents in group 1 were reduced by 25-50% compared to doses before the start of the study. Circulating levels of prolactin, testosterone, free calculated testosterone, dehydroepiandrosterone-sulphate, oestradiol and gonadotropins were measured upon enrolment in the study and six months later. Moreover, at the beginning and the end of the study, all men enrolled completed questionnaires assessing sexual functioning (IIEF-15) and depressive symptoms (BDI-II). RESULTS: Group 1 differed from groups 2 and 3 in domain scores for sexual desire and erectile function, and in the overall BDI-II score. It was also characterised by lower levels of total testosterone and calculated free testosterone. Reduction of drug doses normalised sexual desire and erectile function, reduced BDI-II scores and increased prolactin as well as total and free calculated testosterone. Groups 2 and 3 did not differ from each other in sexual functioning, depressive symptoms or hormone levels. CONCLUSIONS: The results obtained indicate that men with dopamine agonist-induced hypoprolactinaemia are characterised by impaired sexual functioning and reduced wellbeing. These disturbances are a consequence of subnormal prolactin levels and do not seem to reflect adverse effects of dopamine agonists.

Comparison of sexual function between women with iatrogenic and natural menopause / Comparación de la función sexual entre mujeres con menopausia iatrogénica y natural

Introduction: Menopause refers to the permanent cessation of menstruation resulting from the loss of ovarian activity. Studies have shown that menopause has an impact on the life quality of women as well as their sexual function. In this study, we sought to characterise the differences in the sexual function of women with iatrogenic menopause and those with natural menopause.Methods: Data were collected from 300 women in this study. The Symptom Check List and the Female Sexual Function Index were the main data collection instruments. Forty-eight patients with a Symptom Check List score ≥0.5 were not included in the study. Therefore, we enrolled a cohort of 252 menopausal women at a tertiary care setting in Turkey. The independent sample t-test, one-way analysis of variance, Pearson correlation and logistic regression analysis were used in this study and p value of <0.05 was considered statistically significant.Results: In our study, menopause women were divided into two equal groups based on the type of menopause (natural vs. iatrogenic). The iatrogenic group was further divided into 3 sub-groups; drug-induced 30 (12%), radiotherapy-induced 18 (7%) and surgical 78 (31%). No significant difference in sexual function between groups were observed with respect to mean scores for desire, arousal, lubrication, orgasm, satisfaction, pain and sexual function (p>0.05).Conclusions: Our results suggest that sexuality-specific problems during menopause are multifactorial and not solely attributable to biological or psychological factors. Our findings call for comprehensive interventions to address the psychological and biological effects of menopause in order to improve the life quality of women. (AU)

Introducción: La menopausia se refiere al cese permanente de la menstruación como resultado de la pérdida de la actividad ovárica. Los estudios han demostrado que la menopausia tiene un impacto en la calidad de vida de las mujeres, así como en su función sexual. En este estudio, buscamos caracterizar las diferencias en la función sexual de las mujeres con menopausia iatrogénica y aquellas con menopausia natural.Métodos: Se recopilaron datos de 300 mujeres en este estudio. La lista de verificación de síntomas y el índice de función sexual femenina fueron los principales instrumentos de recolección de datos. Cuarenta y ocho pacientes con una puntuación de la lista de verificación de síntomas ≥0,5 no fueron incluidas en el estudio. Por lo tanto, inscribimos una cohorte de 252 mujeres menopáusicas en un entorno de atención terciaria en Turquía. En este estudio se utilizó la prueba t de muestra independiente, el análisis de varianza unidireccional, la correlación de Pearson y el análisis de regresión logística, y se consideró estadísticamente significativo un valor de p<0,05.Resultados: En nuestro estudio, las mujeres con menopausia se dividieron en dos grupos iguales según el tipo de menopausia (natural versus iatrogénica). El grupo iatrogénico se dividió en tres subgrupos: inducida por fármacos 30 (12%), inducida por radioterapia 18 (7%) y quirúrgica 78 (31%). No observamos ninguna diferencia significativa en la función sexual entre los grupos con respecto a las puntuaciones medias de deseo, excitación, lubricación, orgasmo, satisfacción, dolor y función sexual (p>0,05).Conclusiones: Nuestros resultados sugieren que los problemas específicos de la sexualidad durante la menopausia son multifactoriales y no solo atribuibles a factores biológicos o psicológicos. Nuestros hallazgos requieren intervenciones integrales para abordar los efectos psicológicos y biológicos de la menopausia a fin de mejorar la calidad de vida de las mujeres. (AU)

Comparison of sexual function between women with iatrogenic and natural menopause.

INTRODUCTION: Menopause refers to the permanent cessation of menstruation resulting from the loss of ovarian activity. Studies have shown that menopause has an impact on the life quality of women as well as their sexual function. In this study, we sought to characterise the differences in the sexual function of women with iatrogenic menopause and those with natural menopause. METHODS: Data were collected from 300 women in this study. The Symptom Check List and the Female Sexual Function Index were the main data collection instruments. Forty-eight patients with a Symptom Check List score ≥0.5 were not included in the study. Therefore, we enrolled a cohort of 252 menopausal women at a tertiary care setting in Turkey. The independent sample t-test, one-way analysis of variance, Pearson correlation and logistic regression analysis were used in this study and p value of <0.05 was considered statistically significant. RESULTS: In our study, menopause women were divided into two equal groups based on the type of menopause (natural vs. iatrogenic). The iatrogenic group was further divided into 3 sub-groups; drug-induced 30 (12%), radiotherapy-induced 18 (7%) and surgical 78 (31%). No significant difference in sexual function between groups were observed with respect to mean scores for desire, arousal, lubrication, orgasm, satisfaction, pain and sexual function (p>0.05). CONCLUSIONS: Our results suggest that sexuality-specific problems during menopause are multifactorial and not solely attributable to biological or psychological factors. Our findings call for comprehensive interventions to address the psychological and biological effects of menopause in order to improve the life quality of women.

Disfunción sexual en cáncer de mama: Efecto colateral / Sexual dysfunction in breast cancer: A side effect

Introducción: La disfunción sexual femenina (DSF) incluye un grupo de alteraciones en el deseo sexual, excitación, lubricación, satisfacción, orgasmo, y dispareunia, de carácter multifactorial, involucrando tanto procesos orgánicos y psicológicos como socioculturales. Los diversos tratamientos médico-quirúrgicos, tienen impacto en la función sexual. La disfunción sexual femenina afecta la calidad de vida, con una prevalencia de hasta 45-90% en las pacientes con diagnóstico de cáncer de mama. Objetivo: Evaluar la función sexual en mujeres con cáncer de mama, con seguimiento oncológico mayor al año, evaluando el impacto de los diferentes tratamientos médico-quirúrgicos en el índice de función sexual femenina. Material y método: Estudio observacional, descriptivo y transversal, donde se incluyeron 102 pacientes entre agosto 2019 y febrero de 2020 con cáncer de mama en el Hospital Municipal de Oncología María Curie. Como instrumento de medida se utilizó el cuestionario *Índice De Función Sexual Femenina* (FSFI), asociado a una encuesta para la obtención de datos sociodemográficos e información sobre los procedimientos medico-quirúrgicos realizados para el tratamiento del cáncer de mama. Resultados: La media de edad de las pacientes fue 54.86 años (SD 9.19). El 69.6% de ellas habían realizado tratamiento quirúrgico conservador, mientras que el 30.4% estaban mastectomizadas, no evidenciándose diferencias estadísticamente significativas en relación a la disfunción sexual en ambos grupos. Se realizó tratamiento quimioterápico en 69.6% del total de las pacientes y 75.5% hormonoterapia, observándose diferencia en el score FSFI al cotejar el tipo de hormonoterapia recibida. La prevalencia de disfunción sexual en este grupo fue de 82,35%. Los resultados evidenciaron valores bajos en la escala FSFI, siendo la media 19.6, lo que demuestra alteraciones en la función sexual en esta población. Conclusiones: El cáncer de mama posee un impacto multidimensional en la salud sexual de mujeres con cáncer de mama, constituyendo un elemento que influye en la calidad de vida. Los diversos tratamientos médico-quirúrgicos alteran la sexualidad, no pudiendo aún establecerse la relación directa que tienen sobre esta esfera

Introduction: Female sexual dysfunction (FSD) includes a group of alterations in sexual desire, arousal, lubrication, satisfaction, orgasm, and dyspareunia, of multifactorial character, involving organic and psychological as well as sociocultural processes. The various medical-surgical treatments have an impact on sexual function. Female sexual dysfunction affects quality of life, with a prevalence of up to 45-90% in patients diagnosed with breast cancer. Objective: To evaluate sexual function in women with breast cancer, with oncologic followup of more than one year, evaluating the impact of different medical-surgical treatments on the index of female sexual function. Material and method: Observational, descriptive and cross-sectional study, where 102 pa- tients were included between August 2019 and February 2020 with breast cancer at the Maria Curie Municipal Oncology Hospital. As a measurement instrument, the questionnaire *Female Sexual Function Index* (FSFI) was used, associated with a survey to obtain sociodemographic data and information on the medical-surgical procedures performed for the treatment of breast cancer. Results: The mean age of the patients was 54.86 years (SD 9.19). Of these, 69.6% had undergone conservative surgical treatment, while 30.4% were mastectomized, with no statistically significant differences in relation to sexual dysfunction in the two groups. Chemotherapy treatment was performed in 69.6% of the total patients and 75.5% hormone therapy, showing a difference in the FSFI score when comparing the type of hormone therapy received. The prevalence of sexual dysfunction in this group was 82.35%. The re- sults showed low values on the FSFI scale, with a mean of 19.6, which demonstrates alterations in sexual function in this population. Conclusions: Breast cancer has a multidimensional impact on the sexual health of women with breast cancer, constituting an element that influences the quality of life. The various medical-surgical treatments alter sexuality, although the direct relationship they have on this sphere cannot yet be established

Factor structure, internal consistency and distribution of Female Sexual Function Index among Mexican women with early diagnostic of breast cancer / Estructura factorial, consistencia interna y distribución del Índice de Función Sexual Femenina entre mujeres mexicanas con diagnóstico temprano de cáncer de mama

Background: Female Sexual Dysfunction (FSD) occurs frequently in women with breast cancer due to oncologic treatments. It is essential to have a validated instrument to diagnose and quantify FSD in this population accurately. Objective: To validate the Female Sexual Function Index (FSFI). Method: The FSFI was applied to 272 sexually active Mexican women with recent diagnosis of breast cancer who had not initiated systemic cancer treatment. Results: The FSFI six-factor model is valid by confirmatory factor analysis, and the inventory and its factors have adequate internal consistency reliability. Conclusions: This study provides enough evidence about the reliability and factor structure of the FSFI questionnaire in the context of breast cancer clinical practice in Mexico (AU)

Antecedentes: La disfunción sexual femenina (FSD) ocurre con frecuencia en mujeres con cáncer de mama debido a los tratamientos oncológicos. Es fundamental contar con un instrumento validado para diagnosticar y cuantificar la FSD en esta población con precisión. Objetivo Validar el Índice de Función Sexual Femenina (FSFI). Método: El FSFI se aplicó a 272 mujeres mexicanas sexualmente activas con diagnóstico reciente de cáncer de mama que no habían iniciado tratamiento oncológico sistémico. Resultados: El modelo de seis factores de la FSFI se validó por análisis factorial confirmatorio y el inventario y sus factores tienen una fiabilidad de consistencia interna adecuada. Conclusiones: Este estudio proporciona suficiente evidencia sobre la confiabilidad y la estructura factorial del cuestionario FSFI en el contexto de la práctica clínica del cáncer de mama en México (AU)

Sexual function and depressive symptoms in men with hypoprolactinaemia secondary to overtreatment of prolactin excess: A pilot study.

BACKGROUND: Low prolactin levels have been found to impair libido and arousal, as well as to reduce wellbeing in young women. OBJECTIVE: The aim of this study was to investigate whether drug-induced hypoprolactinaemia affects male sexual function and depressive symptoms. METHODS: The study population consisted of three groups of young and middle-aged men. Two groups were treated with dopamine agonists because of previous hyperprolactinaemia but differed in current prolactin levels, which were <3ng/ml (n=12; group 1) or within the reference range (3-20ng/ml) (n=20; group 2). The control group (group 3) included 24 dopamine agonist-naïve normoprolactinaemic men. During the study, doses of dopaminergic agents in group 1 were reduced by 25-50% compared to doses before the start of the study. Circulating levels of prolactin, testosterone, free calculated testosterone, dehydroepiandrosterone-sulphate, oestradiol and gonadotropins were measured upon enrolment in the study and six months later. Moreover, at the beginning and the end of the study, all men enrolled completed questionnaires assessing sexual functioning (IIEF-15) and depressive symptoms (BDI-II). RESULTS: Group 1 differed from groups 2 and 3 in domain scores for sexual desire and erectile function, and in the overall BDI-II score. It was also characterised by lower levels of total testosterone and calculated free testosterone. Reduction of drug doses normalised sexual desire and erectile function, reduced BDI-II scores and increased prolactin as well as total and free calculated testosterone. Groups 2 and 3 did not differ from each other in sexual functioning, depressive symptoms or hormone levels. CONCLUSIONS: The results obtained indicate that men with dopamine agonist-induced hypoprolactinaemia are characterised by impaired sexual functioning and reduced wellbeing. These disturbances are a consequence of subnormal prolactin levels and do not seem to reflect adverse effects of dopamine agonists.

Climacturia after robot-assisted laparoscopic radical prostatectomy.

INTRODUCTION: Adverse effects in the sexual sphere are common in patients who have undergone radical prostatectomy (RP). Climacturia, involuntary loss of urine during orgasm, occurs in 20-40% of cases after PR. We analyse its prevalence and associated risk factors after Robotic-assisted laparoscopic radical prostatectomy (RALRP). OBJECTIVES: We analyse the climacturia prevalence after robotic-assisted laparoscopic radical prostatectomy (RALRP) and the association with other related factors. MATERIALS AND METHODS: Retrospective study of 100 patients underwent PRLAR from May 2011 to July 2014. After excluding patients who received radiotherapy after surgery (17), those who did not have sexual activity (7) and those with whom it could not be possible contacted (14), a structured telephone interview was conducted in 62 patients, investigating: presence and intensity of climacturia, orgasmic quality, incontinence and erectile dysfunction (ED). Other factors analysed included neurovascular preservation and rehabilitative treatment for ED. The statistical analysis consisted of Chi2test and logistic regression to evaluate associated factors. RESULTS: The mean age was 56 vs 59 years and the mean follow-up time was 26.6 vs 20.3 months, in the group with climacturia and without climacturia, respectively. The prevalence of climacturia was 17.9% (slight leaks-82% and severe leaks-18%). In 37% of these patients occurred in all orgasms. The quality of orgasm after surgery was worse in 47%, better in 13% and equal in 40%. The quality of the orgasm worsened more frequently in the climacturia group (63% vs 37%). The urinary incontinence rate was 41%, always effort incontinence. It was more frequent in patients with climacturia (62% vs 38%). In all patients with climacturia, bilateral neurovascular bundles preservation was performed. 32% of the patients had undergone post-surgical erectile rehabilitation with oral drugs. No statistically significant differences were found between patients with or without climacturia respect to the parameters analysed. CONCLUSIONS: Climacturia rate after PRLAR in our series was 17.9%. Patients with climacturia presented worse quality orgasms and a higher incontinence rate (p> 0.05). None of the analysed parameters could be defined as predictors of climacturia.

Shock wave lithotripsy deteriorates male sexual functions related to the treatment-driven anxiety: A prospective, non-randomized, self-controlled study. / La litotricia extracorporea deteriora la función sexual masculina en relación a la ansiedad por el tratamiento: un estudio prospectivo, no randomizado auto-controlado.

OBJECTIVES: This study aims to investigatel ongitudinal changes in sexual functions (SF), anxiety status, and health-related quality of life (HRQoL) after shock wave lithotripsy (SWL) in male urolithiasis patients. METHODS: Between February 2015 and April 2017, 85 consecutive male patients with kidney or ureter stones and treated with SWL were included. Patients were evaluated for SF, anxiety status, and HRQoL with questionnaire forms before and at the third month after SWL. Correlation between baseline and third-month scores of International Index of Erectile Function-15 (IIEF-15) subdomains and anxiety was evaluated. Uni- and multivariable linear regression analyses were used to identify changes in IIEF-15 subdomain scores at three months. RESULTS: Mean age was 42.80 ± 9.42 years. Significantly decreased IIEF-15 subdomain scores, increased anxiety and Short Form-36 (SF-36) subdomain scores were achieved at three months (p<0.05, for each). The baseline median values of erectile function (IIEFEF), orgasmic function (IIEF-OF), sexual desire (IIEF-SD), intercourse satisfaction (IIEF-IS), and overall satisfaction (IIEF-OS) were 26, 9, 8, 12, and 8, respectively. The same scores were 26, 9, 6, 9, and 8 at month 3, respectively. According to multivariable analysis, the difference in Beck Anxiety Inventory (BAI) scores was an independent risk factor for both changing in IIEF-SD and IIEF-IS (b= -0.094, 95%CI: -0.179 - -0.009, p=0.030 and b= -0.197, 95%CI: -0.350 - -0.044, p=0.012, respectively). The difference in the State Anxiety (STAISA) scores was an independent risk factor for changing in IIEF-IS (b= -0.075, 95%CI: -0.146 - -0.004,p=0.039). CONCLUSIONS: SWL may lead to impaired SF related to treatment-driven anxiety and significantly improve HRQoL of male patients in short term.

OBJETIVO: Este estudio tiene como objetivo investigar los cambios longitudinales en la función sexual, estado de ansiedad y calidad de vida después de la litotricia extracorpórea en pacientes varones conlitiasis. MÉTODOS: Entre febrero 2015 y abril 2017, 85 pacientes varones consecutivos con litiasis renales o ureterales tratados con litotricia extracorpórea fueron incluidos. Los pacientes fueron evaluados en relación a la función sexual, estado de ansiedad, y calidad de vida con cuestionarios de calidad de vida antes y a los 3 meses de la litotricia extracorpórea. Correlación entre los resultados de International Index of Erectile Function-15 (IIEF-15) iniciales y a los 3 meses en los dominios de ansiedad, fueron evaluados. Análisis de regresión univariada y multivariada fue utilizada para identificar cambios en IIEF-15 a los 3 meses. RESULTADOS: La edad media fue de 42,80 ± 9,42 años. Una caída significativa de los resultados de los subdominios de IIEF-15 con incremento de la ansiedad y Short Form-36 (SF-36) fueron conseguidos a los 3 meses (p<0,05, para cada uno). Los resultados medios en función eréctil (IIEF-EF), función orgásmica (IIEF-OF), deseo sexual (IIEF-SD), satisfacción en las relaciones (IIEF-IS), y satisfacción general (IIEF-OS) fueron 26, 9, 8, 12, y 8, respectivamente. Los mismos resultados fueron 26, 9, 6, 9, y 8 a los 3 meses, respectivamente. En el análisis multivariado, la diferencia en Beck Anxiety Inventory (BAI) fue un factor de riesgo independiente para ambos, cambiando en IIEF-SD y IIEF-IS (b= -0,094, 95%CI: -0,179 ­ -0,009, p=0,030 y b= -0,197, 95%CI: -0,350 ­ -0,044, p=0,012, respectivamente). La diferencia en el State Anxiety (STAI-SA) fue un factor de riesgo independiente para cambio en IIEF-IS (b= -0,075, 95%CI: -0,146 ­-0,004, p=0,039). CONCLUSIONES: La litotricia extracorpórea comporta cierto grado de disfunción sexual relacionada con la ansiedad del tratamiento y mejora significativamente la calidad de vida en los pacientes varones a corto plazo.

Funções sexual e urinária de gestantes / Sexual and urinary functions of pregnant women / Funciones sexual y urinaria en embarazadas

A Sociedade Internacional de Continência afirma que 69% das mulheres apresentam incontinência urinária (IU) na gravidez. Além disso, ocorrem mudanças relacionadas à função sexual. Entre as principais, destacam-se a dispareunia e o desconforto durante o ato sexual. Este estudo tem como objetivo avaliar as funções urinária e sexual de grávidas atendidas em um centro de saúde escola em Belém (PA). Trata-se de um estudo do tipo transversal, quantiqualitativo, realizado entre junho e setembro de 2018. Foram incluídas mulheres de 18 a 40 anos, entre a nona e a 32ª semana de gestação, com pré-natal no Centro de Saúde Escola do Marco em Belém. Foram excluídas desta análise grávidas com risco gestacional para mãe e feto. Utilizaram-se os questionários International Consultation on Incontinence (ICIQ) e Quociente Sexual (QS-F). Participaram do estudo cinquenta gestantes. De acordo com o ICIQ-SF, 28% das participantes apresentam incontinência urinária muito grave. Segundo o QS-F, 40% das participantes apresentaram desempenho sexual de bom a excelente, porém 54% relataram dor durante a relação sexual. Ficou evidenciado que as grávidas do estudo apresentam alta prevalência de IU e boa/excelente função sexual, devendo-se atentar à prevenção desses sintomas.

The International Continence Society states that 69% of women experience urinary incontinence (UI) and changes related to sexual function, such as dyspareunia and discomfort during the sexual act, during pregnancy. Hence, this study evaluates the urinary and sexual function of pregnant women attended at a school health center in Belém, Pará, Brazil. A cross-sectional, quantitative and qualitative research was conducted between June and September 2018 with women aged 18 to 40 years, between the ninth and 32nd week of gestation, receiving prenatal care at the Escola do Marco Health Center in Belém. Pregnant women with gestational risk for mother and fetus were excluded. Data was collected using the International Consultation on Incontinence (ICIQ) and Sexual Quotient (QS-F) questionnaires. Fifty pregnant women participated in the study. According to the ICIQ-SF, 28.00% of the participants presented very severe urinary incontinence. The Sexual Quotient score showed that 40.00% of the respondents had good to excellent sexual performance, but 54.00% reported experiencing pain during sexual intercourse. Results show that the pregnant women surveyed have a high prevalence of UI and good/excellent sexual function. Attention should be paid to the prevention of these symptoms.

La Sociedad Internacional de Continencia afirma que el 69% de las mujeres tienen incontinencia urinaria (IU) durante el embarazo. Además, se producen cambios relacionados con la función sexual. Entre los principales destacan la dispareunia y las molestias durante el acto sexual. Este estudio tiene como objetivo evaluar las funciones urinaria y sexual de embarazadas atendidas en un centro de salud escolar de Belém, en Pará (Brasil). Se trata de un estudio transversal, cuantitativo-cualitativo, realizado entre junio y septiembre de 2018. Se incluyeron a las mujeres de los 18 a 40 años, entre la novena y la 32ª semana de gestación, con prenatal realizado en el Centro de Saúde Escola do Marco de Belém. Se excluyeron a las embarazadas con riesgo gestacional para la madre y el feto. Se utilizaron los cuestionarios International Consultation on Incontinence (ICIQ) y Quociente Sexual (QS-F). Cincuenta mujeres embarazadas participaron en el estudio. Según el ICIQ-SF, el 28% de las participantes presentan incontinencia urinaria muy grave. El QS-F evidenció que el 40% de las participantes tuvieron un desempeño sexual de bueno a excelente, pero el 54% reportó dolor durante la relación sexual. Se constató que las embarazadas en el estudio tuvieron alta prevalencia de IU y función sexual buena/excelente, y se debe tener cuidado para prevenir estos síntomas.

Relationship between pelvic floor muscle and sexual function in physically active older women / Relação da funcionalidade da musculatura do assoalho pélvico com a função sexual de idosas ativas fisicamente / Relación de la funcionalidad de la musculatura del piso pélvico con la función sexual de las personas mayores activas físicamente

Abstract Introduction: Physical activity is beneficial to psychological and physical health, which ultimately affects sexual health and quality of life. In turn, strong pelvic floor muscles (PFM) can positively affect the sex life of women. Objective: Assess the relationship between pelvic floor muscle and sexual function in physically active older women. Method: 35 sexually and physically active older women with an average age of 69.5 years participated in this study. Physical activity level was assessed with an accelerometer. A diagnostic flow chart and the female sexual function index (FSFI) were applied to assess female sexual function and the PERFECT scheme to assess PFM. Data were collected by two previously trained and blinded researchers and submitted to descriptive statistics and Spearman's correlation. Results: There was a significant correlation between the number of fast-twitch muscle fiber contractions and sexual function (rho = -0.41032; p = 0.0144) and the orgasm dimension (rho = -0.34679; p = 0.0413) in older participants. Conclusion: Pelvic floor muscles are related to female sexual function and it is important for older women to remain physically active.

Resumo Introdução: A atividade física é benéfica à saúde física e psicológica, afeta a saúde sexual e a qualidade de vida. Por sua vez, músculos do assoalho pélvico (MAP) fortes podem ter um efeito positivo na vida sexual das mulheres. Objetivo: Avaliar a relação entre os MAP e a função sexual em mulheres idosas fisicamente ativas. Método: Participaram 35 idosas, sexualmente e fisicamente ativas, com idade média de 69,5 anos. O nível de atividade física foi avaliado com um acelerômetro. Um fluxograma de diagnóstico e índice de função sexual feminina (FSFI) foram aplicados para avaliar a função sexual feminina e o esquema PERFECT para avaliar os MAP. Os dados foram coletados por dois pesquisadores previamente treinados e cegos e submetidos à estatística descritiva e à correlação de Spearman. Resultados: Houve uma correlação significativa entre o número de contrações das fibras musculares de contração rápida e a função sexual (rho = -0,41032; p = 0,0144) e a dimensão do orgasmo (rho = -0,34679; p = 0,0413) nos idosos. Conclusão: Os MAP estão relacionados à função sexual feminina e é importante que as mulheres idosas permaneçam fisicamente ativas.

Resumen Introducción: La actividad física aporta beneficios para la salud física y psicológica, lo que influencia la salud sexual y la calidad de vida. Por su parte, los músculos del piso pélvico (MAP) cuando están bien entrenados, pueden influir positivamente en la vida sexual de las mujeres. Objetivo: Relacionar la funcionalidad de la musculatura del piso pélvico con la función sexual de mujeres ancianas activas físicamente. Método: Participaron en el estudio 35 ancianas sexual y físicamente activas con una edad promedio de 69,5 años. El nivel de actividad física se evaluó por medio del acelerómetro. Se aplicó una ficha diagnóstica, Índice de Función Sexual Femenina para evaluar la función sexual femenina, y la evaluación de los músculos del piso pélvico se realizó por medio del esquema PERFECT. La recolección de datos se realizó por pares y a ciegas, con dos investigadoras previamente entrenadas. Los datos fueron tratados por la estadística descriptiva y la correlación de Spearman. Resultados: Hubo correlación significativa entre el número de contracciones rápidas de fibras de la musculatura del suelo pélvico y la función sexual (rho = -0,41032, p = 0,0144) y la dimensión orgasmo (rho = -0,34679; p = 0,0413) en las ancianas investigadas. Conclusión: La musculatura del piso pélvico está relacionada con la función sexual femenina, destacando la importancia de mantenerse activa físicamente en la vejez.

Función sexual y calidad de vida relacionada con la salud en mujeres climatéricas con prolapso genital en Centros de Salud Familiar de la región de Ñuble / Sexual function and health related quality of life in climacteric women with genital prolapse in Family Health Centers of the Ñuble region

RESUMEN Introducción y objetivos: Los síntomas de climaterio junto con el prolapso genital en la mujer que envejece, afectan la función sexual y la calidad de vida relacionada con la salud. El objetivo de este estudio fue describir la función sexual y la calidad de vida relacionada con la salud en mujeres climatéricas con prolapso genital según características sociodemográficas y clínicas. Métodos: Diseño descriptivo de corte transversal, sobre una muestra consecutiva de 45 mujeres climatéricas inscritas en dos Centros de Salud Familiar de la región de Ñuble, se seleccionaron a todas aquellas entre 42 y 60 años de edad, con diagnóstico clínico o ecográfico de prolapso genital, con vida sexual activa los últimos 6 meses y sin terapia hormonal de reemplazo. Para evaluar la función sexual se aplicó el Índice de Función Sexual Femenina y para la calidad de vida relacionada con la salud el Menopause Rating Scale. Se utilizó estadística descriptiva, y para analizar la diferencia entre las variables se aplicaron las pruebas estadísticas Chi-cuadrado y Test Exacto de Fisher. En todos los casos se consideró un nivel de significancia p<0,05. Los datos fueron analizados con el software estadístico SPSS v. 23. Resultados: Se observó una diferencia estadísticamente significativa entre escolaridad y función sexual (p= 0,005) y el tipo de parto y la calidad de vida relacionada con la salud (p=0,034). Conclusiones: El nivel educacional se podría considerar como factor protector de la función sexual.

SUMMARY Introduction and objectives: The climacteric symptoms together with genital prolapse in the aging woman, affects the sexual function and the health related quality of life. The objective of this study was to describe sexual function and health related quality of life in climacteric women with genital prolapse according to sociodemographic and clinical characteristics. Methods: Descriptive cross-sectional design, on a consecutive sample of 45 climacteric women enrolled in two Family Health Centers of the Ñuble region, were selected all those between 42 and 60 years of age, with a clinical or ultrasound diagnosis of genital prolapse, with active sexual life the last 6 months and without hormone replacement therapy. To evaluate sexual function the Index of Feminine Sexual Function was applied and for the health related quality of life the Menopause Rating Scale was applied. Descriptive statistics were used, and to analyze the difference between the variables, the Chi-square and Fisher's Exact test were applied. In all cases a level of significance was considered p <0.05. The data was analyzed with the statistical software SPSS v. 23. Results: A statistically significant difference was observed between schooling and sexual function (p = 0.005) and type of delivery and health related quality of life (p = 0.034). Conclusions: The educational level could be considered as a protective factor of sexual function.

The effect of sleeve gastrectomy technique on women's sexual function: A prospective study.

INTRODUCTION: Obesity may lead to a serious deterioration in general quality of daily life and sexual functionality. Bariatric surgery is the most effective treatment method for obesity and related morbidities so far and it is better than some medical treatment modalities. In this study, we aimed to investigate the effects of bariatric surgery and especially sleeve gastrectomy, which has been currently performed in increasing numbers on female sexual functions and quality of life. MATERIALS AND METHODS: A total of 53 patients were included to the current study. The participants were selected from eligible individuals who have undergone laparoscopic sleeve gastrectomy operation in our center between April 2014 and March 2015 dates. Age, body weights and body mass indexes (BMIs) of the patients were pre-operatively recorded. The patients have completed the Female Sexual Function Index (FSFI), Beck Depression Scale and SF-36 (Short form-36) forms before and after the surgery. Additionally, post-operative decrease in body weights and mean BMI were recorded. RESULTS: Following bariatric surgery, sexual functions of the female patients improved and total FSFI scores increased. When FSFI scores were analyzed, it was observed that sexual desire, sexual arousal, lubrication, orgasm and sexual satisfaction increased, while the pain parameter has not changed. CONCLUSION: Recent literature reveals that unfavorable effects of increasingly prevalent obesity on sexual functions cannot be denied. We think that sleeve gastrectomy can obtain considerable weight loss, improvement in self-esteem, decrease in anxiety, amelioration in sexual functions and general quality of life.

Evaluation of sexual function in women with labia minora hypertrophy: A preliminary study.

OBJECTIVE: To compare the sexual functions in women with labia minora hypertrophy and age-matched healthy controls. MATERIAL AND METHOD: 43 patients with labia minora hypertrophy and 30 age-matched healthy controls were enrolled in the present study. The sexual functions of the women were evaluated by using the index of female sexual function (IFSF). RESULTS: Mean ages of the patients and controls were 30.06±7.11 and 31.34±4.12 (p=0.41), respectively. Mean total IFSF scores of the patients and controls were 24.18±3.24 and 27.53±4.43 (p<0.05), respectively. The subscale scores of IFSF-lubrication, orgasm, satisfaction and pain in the patient group were significantly lower than in the control group (respectively, p<0.001, p<0.05, p<0.001 and p<0.05). There was no statistically significant difference between IFSF-arousal scores of the patient and control groups (p=0.30). The mean IFSF-desire scores of the patient group was higher than the controls (p<0.001). Labia minora hypertrophy was significantly associated with female sexual dysfunction (odds ratio [OR]=14.97, 95% confidence interval [Cl]=[3.66-61.21], p<0.001). CONCLUSION: This study suggests that patients with labia minora hypertrophy have poorer lubrication, satisfaction, pain, and orgasm scores on the IFSF scale compared to age-matched healthy controls.