Sexual life experiences after myocardial infarction: A systematic review and synthesis of qualitative studies.

AIM: This study aims to systematically interpret and synthesize the data obtained from qualitative research about the sexual lives of individuals who have experienced myocardial infarction. METHODS AND RESULTS: A thorough literature review was conducted between November and December 2023 across five electronic databases: PubMed, Web of Science, CINAHL, EBSCO, and Science Direct Embase. This article includes 12 studies published in English since 2000 that have examined the sexual experiences of individuals who have experienced myocardial infarction. This research adhered to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. We utilized the Critical Appraisal Skills Programme tool for qualitative research to evaluate the quality of all the papers included. To synthesize the data, the deductive and interpretation technique according to Sandelowski and Barroso's approach has been used. The sexual experiences of individuals who have experienced myocardial infarction were summarized under four main themes: changes in sexual life, barriers to engaging in sexual intercourse, an unmet need: information, and sexuality as a part of routine care. CONCLUSION: Patients' expectations from counseling services regarding sexuality after MI are oriented towards these services providing more comprehensive information and incorporating multidisciplinary approaches. This demand clearly indicates the complex and multidimensional changes in sexual life after MI and underscores the necessity for healthcare professionals to play a more active role in this area. REGISTRATION: PROSPERO CRD42023483112.

The Effect of Sexual Counseling Based on PLISSIT and EX-PLISSIT Models on Sexual Function, Satisfaction, and Quality of Life: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis study aimed to investigate the effect of sexual counseling based on PLISSIT (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) and EX-PLISSIT models on sexual function, satisfaction, and quality of sexual life. We searched seven electronic databases (MEDLINE, CINAHL, Web of Science, Cochrane Library, ProQuest, Scopus, and PubMed). Studies published between January 1, 2010, and August 16, 2022, were included in the search. Eighteen articles were eligible for inclusion in the analysis. There was a significant difference in the sexual function scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (standardized mean difference (SMD): 1.677; 95% CI 0.668, 2.686; p < 0.05) and "sexual and communication satisfaction" sub-dimension of sexual life quality (SMD: 0.748; 95% CI 0.022, 1.475; p < 0.05). There was no difference in the sexual satisfaction (SMD: 0.425; 95% CI - 0.335, 1.184; p > 0.05) and quality of sexual life scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (SMD: - 0.09; 95% CI - 0.211, 0.032; p > 0.05). PLISSIT and EX-PLISSIT models-based sexual counseling on sexual function was affected by the moderator variables of the time of evaluation of the results after the intervention, type of comparison group, the study population, and by whom the intervention was applied. Sexual counseling based on the PLISSIT and EX-PLISSIT models improved sexual function scores and "sexual and communication satisfaction" sub-dimension of sexual life quality.

Sexually transmitted infections, sexual life and risk behaviours of people living with schizophrenia: systematic review and meta-analysis.

BACKGROUND: Sexually transmitted infections (STIs), along with sexual health and behaviour, have received little attention in schizophrenia patients. AIMS: To systematically review and meta-analytically characterise the prevalence of STIs and sexual risk behaviours among schizophrenia patients. METHOD: Web of Science, PubMed, BIOSIS, KCI-Korean Journal Database, MEDLINE, Russian Science Citation Index, SciELO and Cochrane Central Register were systematically searched from inception to 6 July 2023. Studies reporting on the prevalence or odds ratio of any STI or any outcome related to sexual risk behaviours among schizophrenia samples were included. PRISMA/MOOSE-compliant (CRD42023443602) random-effects meta-analyses were used for the selected outcomes. Q-statistics, I2 index, sensitivity analyses and meta-regressions were used. Study quality and publication bias were assessed. RESULTS: Forty-eight studies (N = 2 459 456) reporting on STI prevalence (including 15 allowing for calculation of an odds ratio) and 33 studies (N = 4255) reporting on sexual risk behaviours were included. Schizophrenia samples showed a high prevalence of STIs and higher risks of HIV (odds ratio = 2.11; 95% CI 1.23-3.63), hepatitis C virus (HCV, odds ratio = 4.54; 95% CI 2.15-961) and hepatitis B virus (HBV; odds ratio = 2.42; 95% CI 1.95-3.01) infections than healthy controls. HIV prevalence was higher in Africa compared with other continents and in in-patient (rather than out-patient) settings. Finally, 37.7% (95% CI 31.5-44.4%) of patients were sexually active; 35.0% (95% CI 6.6-59.3%) reported consistent condom use, and 55.3% (95% CI 25.0-82.4%) maintained unprotected sexual relationships. CONCLUSIONS: Schizophrenia patients have high prevalence of STIs, with several-fold increased risks of HIV, HBV and HCV infection compared with the general population. Sexual health must be considered as an integral component of care.

Qualitative exploration of sexual dysfunction and associated coping strategies among Iranian prostate cancer survivors.

OBJECTIVE: Our understanding of the experiences of prostate cancer survivors regarding their sexual life and related issues remains limited. Therefore, this study aimed to explore sexual dysfunction and associated coping strategies among Iranian prostate cancer survivors. METHODS: A qualitative study was undertaken. Participants were 15 Iranian prostate cancer survivors chosen using purposeful sampling. Data collection involved conducting in-depth semi-structured interviews, followed by the utilization of the conventional qualitative content analysis method for data analysis. RESULTS: Three themes were developed: (a) suspension of sexual life-treatment for prostate cancer significantly impacted participants' sexual lives; (b) emotional resilience and psychological coping strategies-various psychological strategies were used to tackle sexual dysfunction; (c) efforts to regain sexual function-several strategies were applied to enhance sexual performance. CONCLUSION: Our study findings provide insights into the experiences of prostate cancer survivors and subsequent shifts in their sexual dynamics and coping with the disease. Healthcare providers should actively identify patients' concerns and develop culturally tailored care strategies to address sexual challenges and improve coping among prostate cancer survivors.

Sexual experiences of postmenopausal women in China: a qualitative study.

Background: Sexual dysfunction is common among postmenopausal women and can have a significant negative impact on quality of life. Aim: This study aimed to explore perceptions, experiences, and coping strategies related to sex among postmenopausal women in China. Methods: We used phenomenologic qualitative methods in this study. On the basis of purposive sampling and the data saturation principle, 21 volunteers from a community cohort study were selected for semistructured interviews. The data were analyzed and themes were extracted. Outcomes: Thematic codes pertaining to sexual experiences and coping strategies were defined and assessed in this study. Results: Four themes and 12 subthemes were extracted from the interview data. The sexual concepts were relatively conservative for most of the Chinese women; the majority experienced physical and psychological distress with respect to sex, although negative and positive psychological experiences were described. The women often passively accepted and adapted to negative changes to their sex lives during the postmenopause period. Clinical Implications: This study highlights the importance of and need for effective dissemination of sexual health-related knowledge and the opening of appropriate communication channels. Strengths and Limitations: By using a qualitative approach, this study provides individuals with the opportunity to describe their cognition and attitudes toward sexuality. Limitations include limited generalizability, as is true for most qualitative research. Additionally, the study is based solely on the female perspective and cannot fully reflect the sex life of couples. Conclusion: The sexual experiences of our respondents exhibited distinct Chinese cultural characteristics. The interviews show the importance of paying attention to postmenopausal women's sexual health and providing relevant professional support and guidance to improve women's overall health-related quality of life.

Is Instagram destroying sex life? An analysis of the impact of social media use on the sexual life of young Polish women - results of a web-based cross-sectional survey.

INTRODUCTION AND OBJECTIVE: Various types of social media (SM) have recently played a huge role in shaping the world and one's self-esteem. Previous research on this issue has shown that frequent use of MS leads to the creation of unrealistic body image ideals. Time spent on SM is sometimes associated with increased body dissatisfaction, which could negatively affect sex life. OBJECTIVE: The aim of this STROBE (Strengthening the Reporting of Observational Studies)-compliant cross-sectional and web-based study was to determine the relationship between MS use by young women in Poland and various aspects of their sexuality, such as self-perception, self-esteem, and satisfaction with their sex lives. MATERIAL AND METHODS: A group of 1,258 young women aged 18-35 who use SM completed an online survey containing questions about socio-demographic data, SM use and questionnaires: Self-Esteem and Appearance Scale (BESAA), Self-Awareness of Own Body Scale (BISC) Women's Sexual Satisfaction Scale (SSS-W). RESULTS: There was a significant relationship between time spent in SM and women's self-perception (p<0.001). The longer the time spent on SM, the lower the evaluation of one's own body, as well as lower satisfaction with sexual life (p=0.013). Comparing oneself and being compared to those seen on SM, significantly predicts the level of satisfaction with body evaluation and appearance (p<0.001), body image disturbance (p<0.001), and sexual satisfaction (p<0.001), significantly explains the final score of the BESAA (20%), BISC (16.2%) and SSS-W (4%) scales. CONCLUSIONS: The study revealed the need to raise awareness among young women about the negative impact of SM on self-esteem and body image. It is necessary to educate how much self-esteem and sexual satisfaction are affected by the phenomenon of comparing oneself to influencers seen on SM, as well as being compared by others.

Satisfaction with sex life and its impact on the quality of life in people living with HIV in Poland treated in the city of Bialystok: a cross-sectional study.

Introduction: Sex life is an important element contributing to the overall quality of life. It is also a particularly sensitive dimension of quality of life for HIV-positive patients. Objective: The aim of the study was to assess the sexual life of people living with HIV in Poland treated in the Observation and Infection Clinic with the Subunit for HIV/AIDS Patients of the University Clinical Hospital in Bialystok, and its impact on the quality of life, life satisfaction, HIV status acceptance, general health status and depressive symptoms among the respondents. Methods: A total of 147 participants, including 104 men (70.7%) and 43 women (29.3%), took part in the research. The study was conducted between May 2019 and January 2020. The study used a diagnostic survey method with a modified questionnaire "Psychosocial situation of people living with HIV/AIDS" by Dr. Magdalena Ankiersztejn-Bartczak and the following standardised psychometric tools: the World Health Organization Quality of Life (WHOQOL-BREF), Short Form Health Survey (SF-36), Acceptance of Illness Scale (AIS), Satisfaction with Life Scale (SWLS), General Health Questionnaire (GHQ-28) and Beck Depression Inventory (BDI). Results: One-third of patients rated their sex life as poor or very poor. Almost half of respondents always informed sexual partners of their HIV status (49.7%). The sex life of respondents was highly correlated with almost all psychometric measures used in the study. Those indicating sexual contact as a possible source of HIV infection had a lower quality of life in the domain of general health compared to other respondents, but the difference was relatively small (about 5.5 points). Discussion: In conclusion, the overall satisfaction with the sex life of people living with HIV was moderate with a tendency to poor. The quality of life of people living with HIV was determined by their sex life. Better quality of life was presented by those with good self-reported sex life.

Sexual function assessment in patients with SAPHO syndrome: a cross-sectional study.

INTRODUCTION: SAPHO syndrome is a group of special syndromes characterized by synovitis, acne, pustulosis, hyperostosis and osteitis. Skin lesions and joint damage are the main clinical manifestations. Among them, females mostly present with palm toe pustulosis, while males have severe acne as the main external manifestation. The bone and joint damage characterized by bone hypertrophy and osteitis is the core manifestation of SAPHO and affects all parts of the body. SAPHO syndrome causes great physical and mental suffering to patients, and it also brings a huge financial burden to the family. The purpose of this study is to explore the impact of SAPHO on the quality of sexual life of patients. METHODS: We screened and included 249 SAPHO patients (169 women and 80 men) from Peking Union Medical College Hospital (Beijing, China). First, we recorded the basic situation of the patient through questionnaires (including gender, age, SAPHO duration, BMI, smoking, drinking, marital status, educational level, occupational status and work status.). Then, the patient needed to fill in the Short Form-36 quality of life questionnaire (SF-36 QoL) to record the quality of life. For Sexual dysfunction (SD), female patients needed to fill in the Female Sexual Function Index (FSFI) to assess the quality of sexual life; while the International Index of Erectile Function (IIEF) was used to assess the SD of male patients. At the same time, we used self-esteem and relationship questionnaire (SEAR) to analyze the psychological state of SAPHO patients. Finally, we performed statistical analysis on the data obtained, and then explored the connection between SAPHO and SD. RESULTS: In this cross-sectional study, a total of 249 patients completed the questionnaire and constituted the study population. We found that among 169 female patients, 124 patients had FSD (73.4%); while 45 patients did not have FSD (26.6%); and among 80 male patients, 45 (56.3%) had ED; However, 35 patients did not have ED (43.7%). The results of the quality of life and mental state assessment showed that female patients with SD showed lower scores in terms of mental state. Among all male participants, we found no significant difference in quality of life and mental state among participants with or without SD. In addition, there was no significant difference in the duration of SAPHO between female and male participants with or without SD. CONCLUSION: This study is the first to evaluate the SD of SAPHO patients. The incidence of SD in female SAPHO patients is higher than that in male patients; the cause of female SD may be mainly psychological factors. These results prove that it is particularly important to focus on regulating their psychological state while diagnosing and treating SAPHO patients in clinical practice.

'Out of the frying pan into the fire': a qualitative study of the impact on masculinity for men living with advanced prostate cancer.

Background: Studies have highlighted how advanced prostate cancer causes biographical disruption and presents challenges to masculine identities for men. This article draws on a wider study that focused on the experiences of men living with advanced prostate cancer and their caregivers. Although men's experience of advanced illness is not overlooked in the literature, only a small body of work has taken an in-depth look at men's experiences with advanced prostate cancer and their caregivers in a non-Westernised cultural and social context. Objective: To explore how advanced prostate cancer impacts on men's masculine identity from the perspective of patients and their caregivers. Methods: A qualitative study of men living with advanced prostate cancer (n = 23) and family caregivers (n = 23) in Ghana. We used the Consolidated Criteria for Reporting Qualitative Studies (COREQ) as the reporting guideline. Results: The findings from this study highlight profound challenges for most men to their masculine identities, from both the treatment and the symptoms of advanced prostate cancer within a non-Westernised, patriarchal society. Four main themes were developed. These were the impact on masculinity in terms of: (1) physical changes, (2) sexual ability, (3) socio-economic roles and (4) expressing emotions. Changes in physical appearance, feeling belittled, having no active sexual life and the inability to continue acting as provider and protector of the family made some men describe their situation as one of moving out of the 'frying pan into the fire'. Conclusion: This study revealed the impact of advanced prostate cancer on masculine identity. These narratives add a new dimension to what is already known about the impacts on men's masculine identities when dealing with advanced prostate cancer. This knowledge can help improve the care provided to men with advanced prostate cancer with emphasis on the cultures, beliefs and aspirations of these men and their caregivers.

Factors influencing the quality of sexual life in the older adults: A scoping review.

Objective: Older people are often considered asexual, but sex is still important for older adults. So, this review aimed to analyze relevant studies on the sexual life of older adults to clarify factors, and provide a basis for their quality of sexual life. Method: A scoping review was performed according to Arksey and O'Malley's framwork, aiming to identify eligible research studies in PubMed, Web of Science, CINAHL, and PsycINFO, Cochrane Library, and Scopus databases. Peer-reviewed articles published in Chinese or English language from January 2012 to April 2022 were retrieved. All of identified studies were screened, extracted, and analyzed independently by two researchers. Result: A total of 7,374 studies were retrieved, and 13 eligible studies were finally included. The factors affect the sexual quality of life in older adults that included physiological, sociocultural, and health factors and being affected by marital relationships and a lack of relevant knowledge. Conclusion: The factors that affect the quality of old people's sex life interact and influence each other. Medical and health professionals can assist with the improvement of sexual health.

Sexual life of Spanish women during the lockdown by COVID-19: Differences according to sexual orientation?

The COVID-19 pandemic may have exacerbated the sexual health differences that already existed among women based on their sexual orientation. Therefore, a total of 971 Spanish women aged 18-60 years (84 % heterosexual and 16 % with a minority sexual orientation) answered an ad hoc online questionnaire about sexual behavior during April 2020. Compared to heterosexual women, sexual minority women showed a greater increase in sexual frequency, masturbated more, had more sex with a housemate, and engaged in more online sexual activities during lockdown. The emotional impact of the pandemic, having privacy, and age showed a relationship with the quality of sexual life, but not sexual orientation. Based on these results, women's sexual lives are not as closely related to their sexual orientation as they are to other variables. Therefore, it seems more necessary to address issues affecting women in general during lockdown than to focus on their specific sexual orientation.

Scoping review of the association between bacterial vaginosis and emotional, sexual and social health.

BACKGROUND: Bacterial vaginosis (BV) is a condition that, if symptomatic, is characterized by discharge and odor, with high recurrence rates even when treated. This study aims to review what literature exists on the association between BV and the emotional, sexual, and social health of women. METHODS: MEDLINE, Embase and Web of Science databases were searched from inception until November 2020. Studies reporting an association between women's emotional, sexual and/or social health and symptomatic BV in a qualitative and/or quantitative manner were included. Selected studies were divided in three categories, i.e. reporting on the emotional, sexual and/or social association. All studies were critically evaluated and discussed. RESULTS: Sixteen studies were included. Concerning emotional health, we found eight studies that calculated the association between stress and BV, in four this was statistically significant. Four qualitative studies on emotional health showed that the severity of the symptoms influenced the impact on women's lives. All studies on sexual health reported that many women experienced an impact on their relationship and sexual intimacy. Results for social life ranged from no association found to most of the study population showing avoidance behavior. CONCLUSION: This review shows that symptomatic BV can be associated with diminished emotional, sexual, and social health, but there is too little evidence to state the extent of this association.

Sexuality and fertility desire in a large cohort of individuals with 46, XY differences in sex development.

OBJECTIVE: To analyze aspects of sexual life and fertility desire among 46, XY DSD people, including those who changed their gender. METHODS: It is a cross-sectional study including 127 adults (> 16 years of age) with 46, XY DSD (83 females; 44 males) from a Single Brazilian Tertiary-Care Medical Center. RESULTS: Sexual fantasies and masturbation were more frequent in 46, XY DSD males, whereas orgasm and sexual life satisfaction were similar in both genders. More 46, XY DSD men than women had a long-term romantic relationship. 46, XY DSD women with prenatal androgen exposure reported more fear of being romantically rejected. External genitalia appearance at birth did not impact the sexuality of 46, XY DSD women after surgical genital treatment had been completed. Overall, the sexual life was similar between 46, XY men assigned as males and those who changed to the male gender. Regarding sexual orientation, most self-reported as heterosexual (91% and 92% of women and men, respectively). The desire for fertility had a similar prevalence in both genders, but more women than men considered infertility a barrier to a long-term romantic relationship. Twelve individuals (7 males) had children; 10 out of 12 have adopted children. CONCLUSION: Fertility desire was shared among 46, XY DSD people, regardless of gender. Prenatal androgen exposure reduced the desire for motherhood in 46, XY women. 46, XY DSD people who changed from female to male gender presented similar sexual parameters as those assigned as males. Among females, virilized genitalia at birth did not affect sexuality once the surgical treatment is completed.

The Prevalence of Andropause and Its Relationship With Sexual Quality of Life Among Older Iranian Men.

Available evidence indicates insufficient knowledge about the status of andropause and sexual quality of life among Iranian older men. The study aimed to investigate the prevalence of andropause and its relationship with sexual quality among older adults. This descriptive-analytical study was conducted among 576 older people referred to urban health centers in Mashhad, Iran. The eligible samples were selected through the cluster sampling method. To collect data, the male andropause symptoms' self-assessment questionnaire and the sexual quality of life-male were used. Forty-seven of the respondents (n = 271) were diagnosed with a "moderate" level of andropause. A strong negative correlation was identified between the sexual quality of life and the severity of andropause (r = -.366, p < .001). Sexual quality of life and andropause was also affected by age, marital status, health status, and exercise. Thirty-six percent of the changes in the quality of sexual life of older men were influenced by the independent variables (adjusted R2 = .36; R2 = .40; R = .63). The findings indicated that andropause has highly prevailed among the participants. There was a meaningful association between andropause and sexual quality of life among older men. Further studies are recommended to investigate sexual orientation qualitatively and to discover other factors influencing andropause among adult men.

Quality of sexual life and associated factors: a cross-sectional survey of Chinese breast cancer patients.

PURPOSE: This study aimed to explore Chinese breast cancer patients' quality of sexual life (QSL) and factors associated with QSL. METHODS: The questionnaires in this cross-sectional study include the general information questionnaire, cognition and assessment of sexual health questionnaire, Self-acceptance Questionnaire (SAQ), Medical Coping Modes Questionnaire (MCMQ), and Quality of Sexual Life Questionnaire (QSLQ); 201 breast cancer patients were required to complete the questionnaires assessing characteristic information, cognition and assessment of sexual health, QSL, self-acceptance, and coping style. Finally, hierarchical regression was used to analyze the factors associated with QSL in Chinese breast cancer patients. RESULTS: The mean age (at the time of the survey) of the breast cancer patients was 48.31±9.15. The mean score of the QSLQ (range 28-140) was 75.14±16.57. Hierarchical regression analysis showed that the associated factors of breast cancer patients' QSL included age (at the time of the survey), education level, type of surgery, cognition and assessment of sexual health, self-acceptance, and avoidance and acceptance-resignation coping styles, that independent variables explained 60.4% of the variance. CONCLUSION: The QSL among Chinese breast cancer patients needs to be improved. Our findings indicated that breast cancer patients with older age, lower education level, or modified radical mastectomy have poor QSL. Breast cancer patients learn correct information about sexual health, enhance self-acceptance, and reduce acceptance-resignation, and avoidance coping could be intervention strategies to improve their QSL.

Examination of the effect of the perceived stress in the coronavirus-19 pandemic on marital adjustment, sexual life and intimate partner violence.

AIMS: The aim of the study was to explore the effects of perceived stress during the pandemic on marital adjustment, sexual life and intimate partner violence. DESIGN: A cross-sectional design was employed in this study. METHODS: The data were collected with an online survey between October and December 2020 from 901 participants in Turkey. Participants completed the Descriptive Information Form, the Marital Adjustment Scale and the Perceived Stress Scale. Multivariate analysis of variance and moderation analysis were used in the analysis of the data. RESULTS: The pre-pandemic marital adjustment scores of the participants significantly decreased during the pandemic. The marital adjustment and sexual life of those with high perceived stress levels were found to be negatively affected, and they were exposed to violence during the pandemic. In the moderation analysis, a non-standardized coefficient of the marital adjustment variable in the model turned out to be significant, and the perceived stress decreased as marital adjustment increased. The marital adjustment was low, and the stress level was high in individuals exposed to violence. Besides, perceived stress was found to be effective in being exposed to intimate partner violence. CONCLUSION: The stress perceived by individuals during the COVID-19 pandemic negatively affected their marital adjustment and sexual life. Besides, perceived stress was found to be effective in being exposed to intimate partner violence, and marital adjustment decreased during the pandemic compared to the pre-pandemic period. IMPACT: During the pandemic period, health care providers should routinely screen the psychosocial health of individuals. Continuous, accessible, free psychosocial support services should be available in order to increase the psychosocial health and marital adjustment of people with high-stress levels and prevent exposure to violence. PATIENT OR PUBLIC CONTRIBUTION: The conduct of this study is based on an online survey with participants living in the same house with their spouses during the pandemic.

Quality of Sexual Life and Attitudes toward Menopause among Postmenopausal Women Living in Northern Cyprus: A Cross-sectional Study.

Background: Most middle-aged women in the menopausal period consider sexuality an important part of life. The aim of the present study was to investigate the factors affecting the quality of sexual life and attitudes toward menopause in postmenopausal women and the effects of their attitudes toward menopause on the quality of sexual life. Materials and Methods: This cross-sectional study was conducted with postmenopausal women in the Turkish Republic of Northern Cyprus between July 2021 and April 2022. The research sample consisted of 255 postmenopausal women. The Attitudes Toward Menopause Scale and the Sexual Quality of Life Scale (SQLS) were used to collect data. The questionnaire forms were administered online. The data were analyzed using the independent t-test, analysis of variance, Tukey's test, Pearson's correlation, and linear regression analysis. Results: The mean score of the participants on the SQLS was 43.54 ± 12.56 and the mean score of the Attitudes Toward Menopause Scale was 60.39 ± 16.29. The study revealed that variables such as age, level of education, employment status, duration of menopause, and knowledge about menopause have an effect on women's sexual life quality. In addition to the listed variables, income level was found to affect attitudes toward menopause. A positive attitude toward menopause causes an increase in the level of sexual life quality (ß = 0.544, R2 = 0.30, F = 106.260, R = 0.544, P = 0.001). Conclusions: The attitudes of postmenopausal women toward menopause are an important determinant of their sexual life quality. For this reason, it is recommended to develop and implement training programs that can improve sexual health of women and their attitudes toward menopause.

Asociación entre el inicio de la vida sexual y las lesiones intraepiteliales / Association between age at onset of active sexual life and intraepithelial lesion

Introducción: El cáncer cervicouterino inicia con una lesión precancerosa llamada displasia, pudiendo ser de bajo grado o alto grado; uno de los factores más importantes en este sentido es la edad de inicio de la vida sexual activa (IVSA). Objetivo: Conocer si existe asociación entre la edad de inicio de la vida sexual activa y la lesión intraepitelial escamosa de alto grado (LIEAG). Material y métodos: Estudio descriptivo, retrospectivo, observacional, en 52 expedientes de mujeres de 15 a 60 años, con Papanicolaou en el HGZ MF No. 1, previa autorización del CLIS 301 y el CEI 3018, con folio R-2022-301-021. Se recolectaron los datos de expedientes que cumplieron los criterios de inclusión; se realizó un análisis estadístico con frecuencias, porcentajes para variables cualitativas nominales, con medidas de tendencia central y dispersión en variables cuantitativas, con determinación de chi2 y prueba de Kruskal-Wallis, respetándose los principios de Belmont en consideración a la Justicia y Beneficencia, los principios éticos de la Declaración de Helsinki 1964 y la Ley General de Salud en México. Resultado: Al evaluar 52 expedientes de pacientes, la edad fue de 37.81 ± 9.949 años; se encontró asociación entre el IVSA y la LIEAG, sin significación estadística, de acuerdo con la prueba de chi2, con un valor de p = 0.538 (IC 95%: 0.403-0.674), y una asociación significativa por la prueba de Kruskal-Wallis entre la LIEAG y la edad de la paciente, con un valor de p = 0.019 (IC 95%: 0.000-0.057). Conclusión: El IVSA no se correlaciona con el tipo de LIEAG.

Introduction: Cervical cancer begins with a precancerous lesion called dysplasia, which can be low grade or high grade. One of the most important factors is the age at which an active sexual life begins. Objective: To know if there is an association between the age of beginning of active sexual life (BASL) and high-grade squamous intraepithelial lesions (HGSIEL). Material and methods: Descriptive, retrospective, observational study, in 52 files of women aged 15 to 60 years with Pap smear at HGZ MF No. 1, prior authorization from CLIS 301 and CEI 3018 with folio R-2022-301-021. Data were collected from files that met the inclusion criteria, a statistical analysis was carried out with frequencies, percentages for nominal qualitative variables, with measures of central tendency and dispersion in quantitative variables, with determination of chi2 and Kruskal-Wallis, respecting the principles of Belmont in consideration of Justice and Beneficence, the ethical principles of the Declaration of Helsinki 1964, the General Health Law in México. Result: When evaluating 52 patient records, the age was 37.81 ± 9.949 years, the association of BASL and HGSIEL was found without statistical significance according to the chi2 with a p = 0.538 (95% CI, 0.403-0.674) and a significant association by Kruskal-Wallis between HGSIEL and patient age, with p = 0.019 (95% CI, 0.000-0.057). Conclusion: The beginning of an active sexual life has no association with the type of high-grade squamous intraepithelial lesions.

Sexuality and fertility desire in a large cohort of individuals with 46, XY differences in sex development

Abstract Objective: To analyze aspects of sexual life and fertility desire among 46, XY DSD people, including those who changed their gender. Methods: It is a cross-sectional study including 127 adults (> 16 years of age) with 46, XY DSD (83 females; 44 males) from a Single Brazilian Tertiary-Care Medical Center. Results: Sexual fantasies and masturbation were more frequent in 46, XY DSD males, whereas orgasm and sexual life satisfaction were similar in both genders. More 46, XY DSD men than women had a long-term romantic relationship. 46, XY DSD women with prenatal androgen exposure reported more fear of being romantically rejected. External genitalia appearance at birth did not impact the sexuality of 46, XY DSD women after surgical genital treatment had been completed. Overall, the sexual life was similar between 46, XY men assigned as males and those who changed to the male gender. Regarding sexual orientation, most self-reported as heterosexual (91% and 92% of women and men, respectively). The desire for fertility had a similar prevalence in both genders, but more women than men considered infertility a barrier to a long-term romantic relationship. Twelve individuals (7 males) had children; 10 out of 12 have adopted children. Conclusion: Fertility desire was shared among 46, XY DSD people, regardless of gender. Prenatal androgen exposure reduced the desire for motherhood in 46, XY women. 46, XY DSD people who changed from female to male gender presented similar sexual parameters as those assigned as males. Among females, virilized genitalia at birth did not affect sexuality once the surgical treatment is completed.

Breastfeeding Sexual Lives of First-Time Mothers: A Qualitative Explorative Study.

Background: Problems with sexuality are experienced in the first 6 months at the most, and often in the first 12 months after birth. Although there are studies reporting negative effects of breastfeeding on sexuality, the evidence is limited. Objective: This study was conducted with the aim of exploring the breastfeeding sexual lives of first-time mothers. Materials and Methods: The research was carried out in Turkey between October 2020 and December 2021. The study was conducted with 41 women who met the inclusion criteria. Participants were selected by the "snowball" sampling procedure among nonprobability sampling methods. A qualitative approach was used to gather data through semistructured interviews. Content analysis was used for data analysis as described by Graneheim and Lundman. Data analysis was performed using NVivo software (Version 11). Results: According to the results of the content analysis, three themes were created: factors affecting sexuality in the breastfeeding process, sexual interaction with the spouse during the breastfeeding process, and understood expectations. The theme, titled factors affecting sexuality in the breastfeeding process, consists of five categories: physical, psychological, sociocultural, infant-related, and health professionals-related factors. The theme of "understood expectations" consists of desires for improving sexual satisfaction and satisfaction during lactation, and sexual communication categories. The contact of sexual interaction with spouse during breastfeeding consists of positive interaction and negative interaction categories. Conclusions: It has been concluded that the sexual intercourse of women is adversely affected during the breastfeeding period and that women have expectations to increase their sexual satisfaction. Sexual problems during the breastfeeding process cause problems in the spousal relationship.