Web-Based Emotion Regulation Training for Sexual Health: Randomized Controlled Trial.

BACKGROUND: Effective emotional regulation (ER) skills are important for sexual function, as they impact emotional awareness and expression during sexual activity, and therefore, satisfaction and distress. Emotion regulation interventions may offer a promising approach to improve sexual health. Web-based emotion regulation may be a therapeutic strategy for men and women with sexual health concerns. Nevertheless, there is a scarcity of intervention trials investigating its effects in this context, much less using the internet. OBJECTIVE: This study aims to investigate the effects of a web-based emotion regulation training program for sexual function in both men and women. METHODS: The participants were recruited based on their self-reported sexual problems, which for men was defined by a score of <25 on the International Index Erectile Function (IIEF) and for women by a score of <26.55 on the Female Sexual Function Index (FSFI). The final sample included 60 participants who were randomized to either a web-based emotion regulation training for sexual function or to a waitlist control group. The treatment consisted of an 8-week web-based emotion regulation training for sexual function. The participants were assessed at baseline, post intervention, and the 3-month follow-up. RESULTS: Of the 60 participants included, only 6 completed all 3 assessment points (n=5, 20% in the treatment group and n=1, 5% in the waitlist control group) after receiving the intervention. At follow-up, there were no significant differences between groups in any measure. Among the intervention completers, large-to-moderate within-group effect sizes were observed between the assessment points on measures of emotion regulation, depression, lubrication, orgasm, thoughts of sexual failure, and abuse during sexual activity. The adherence rate was very low, limiting the generalizability of the findings. CONCLUSIONS: Participants who completed the intervention showed improvements in both sexual function domains and emotion regulation. Nonetheless, due to a high dropout rate, this trial failed to collect sufficient data to allow for any conclusions to be drawn on treatment effects. TRIAL REGISTRATION: ClinicalTrials.gov NCT04792177; https://clinicaltrials.gov/study/NCT04792177.

Disfunción sexual en las mujeres con enfermedad pulmonar obstructiva crónica / Sexual dysfunction in women with chronic obstructive lung disease

Objetivo Determinar la prevalencia de la disfunción sexual en las mujeres con enfermedad pulmonar obstructiva crónica (EPOC) y los factores relacionados con su aparición. Métodos Se llevó a cabo un estudio observacional transversal a lo largo del año 2021, con inclusión de mujeres con EPOC diagnosticadas por espirometría mediante muestreo por conveniencia. Se recogieron datos de edad, tabaquismo, espirométricos, comorbilidades y fármacos utilizados, Además, se realizó un cuestionario de salud sexual. Resultados Se incluyeron 101 mujeres con edad media 59,7 (11,3) años. Todas ellas habían experimentado un cambio en su actividad sexual y 44% lo atribuyeron a la EPOC. Tenía disnea durante el coito 51,5%. La prevalencia de disfunción sexual fue de 52,5%. Las pacientes que experimentaron esto eran de más edad y tenían un índice de Tiffeneau más bajo. Asimismo, con más frecuencia consumían alcohol, tenían hipertensión arterial y enfermedad cerebrovascular, y con menos tenían diabetes e insuficiencia cardiaca. Sin embargo, puntuaban más bajo en el índice de Charlson corregido por edad. Aquellas con disfunción sexual utilizaban con menos regularidad la triple terapia inhalada. Conclusiones La disfunción sexual es frecuente en las mujeres con EPOC. Son necesarios más estudios que investiguen las causas, mecanismos y posibles tratamientos de la misma. (AU)

Objective To determine the prevalence of sexual dysfunction in women with COPD and the factors related to its presence. Methods Cross-sectional observational study during 2021, including women with COPD diagnosed by spirometry through convenience sampling. Data on age, smoking status, spirometric data, comorbidities and medications used were collected. A sexual health questionnaire was administered. Results The study included 101 women with a mean age of 59.7 (11.3) years. All had experienced a change in sexual activity, with 44% attributing it to COPD. Among them, 51.5% experienced dyspnea during coitus. The prevalence of sexual dysfunction was 52.5%. Women with sexual dysfunction were older and had a lower Tiffeneau index. Furthermore, they consumed alcohol more frequently and had hypertension and cerebrovascular disease, and less often, they had diabetes and heart failure. However, they scored lower on the Charlson index corrected for age. Patients with sexual dysfunction used inhaled triple therapy less frequently. Conclusions Sexual dysfunction is common in women with COPD. Further studies are needed to investigate its causes, mechanisms, and potential treatments. (AU)

Role of Nutraceuticals in Treating Erectile Dysfunction via Inhibition of Phosphodiesterase-5 Enzyme: A Mini Review.

Drug repurposing is an ongoing and clever strategy that is being developed to eradicate tuberculosis amid challenges, of which one of the major challenges is the resistance developed towards antibiotics used in standard directly observed treatment, short-course regimen. Surpassing the challenges in developing anti-tuberculous drugs, some novel host-directed therapies, repurposed drugs, and drugs with novel targets are being studied, and few are being approved too. After almost 4 decades since the approval of rifampicin as a potent drug for drugsusceptible tuberculosis, the first drug to be approved for drug-resistant tuberculosis is bedaquiline. Ever since the urge to drug discovery has been at a brisk as this milestone in tuberculosis treatment has provoked the hunt for novel targets in tuberculosis. Host-directed therapy and repurposed drugs are in trend as their pharmacological and toxicological properties have already been researched for some other diseases making the trial facile. This review discusses the remonstrance faced by researchers in developing a drug candidate with a novel target, the furtherance in tuberculosis research, novel anti-tuberculosis agents approved so far, and candidates on trial including the host-directed therapy, repurposed drug and drug combinations that may prove to be potential in treating tuberculosis soon, aiming to augment the awareness in this context to the imminent researchers.

Sexual dysfunction in women with chronic obstructive lung disease.

OBJECTIVE: To determine the prevalence of sexual dysfunction in women with COPD and the factors related to its presence. METHODS: Cross-sectional observational study during 2021, including women with COPD diagnosed by spirometry through convenience sampling. Data on age, smoking status, spirometric data, comorbidities and medications used were collected. A sexual health questionnaire was administered. RESULTS: The study included 101 women with a mean age of 59.7 (11.3) years. All had experienced a change in sexual activity, with 44% attributing it to COPD. Among them, 51.5% experienced dyspnea during coitus. The prevalence of sexual dysfunction was 52.5%. Women with sexual dysfunction were older and had a lower Tiffeneau index. Furthermore, they consumed alcohol more frequently and had hypertension and cerebrovascular disease, and less often, they had diabetes and heart failure. However, they scored lower on the Charlson index corrected for age. Patients with sexual dysfunction used inhaled triple therapy less frequently. CONCLUSIONS: Sexual dysfunction is common in women with COPD. Further studies are needed to investigate its causes, mechanisms, and potential treatments.

Dietary Supplements for Erectile Dysfunction: Analysis of Marketed Products, Systematic Review, Meta-Analysis and Rational Use.

The use of nutraceutical products to enhance male sexual performance has a long history, especially with regard to the treatment of erectile dysfunction (ED). Alternative treatments for ED are becoming increasingly popular, with growing interest from consumers, as well as increased revenue for manufacturers. Dietary supplements (DSs), which are a mixture of active ingredients, are mainly sold online. In randomized controlled trials, the molecules contained in DSs have demonstrated varying degrees of effectiveness, or even have no evidence to support their use. However, none of the studies carried out provided sufficient evidence to consider these products a first-line therapy. Therefore, the combination of the various active ingredients, especially in relation to the daily dose, leaves doubts about the real effectiveness. In order to evaluate the potential efficacy of DS formulations, we analyzed the products marketed in Italy using a scoring approach. A systematic review of the literature was performed to evaluate the effect of DS and to detect the active ingredients able to improve erectile function-called effective ingredients (EIs)-and their minimal effective daily dose (mED). A metanalysis identified some nutraceuticals, such as Panax ginseng, Tribulus terrestris and L-arginine, that are able to improve male sexual function. Based on the scoring system, 2 (8%) supplements matched with the cluster of higher expected efficacy, 3 (12%) with the lower efficacy cluster and 20 (80%) matched with the criterion of no expected efficacy. DSs marketed in Italy are usually blends of many substances that are frequently employed at a negligible dose or without any evidence.

Efficacy of Low-Intensity Extra Corporal Shockwave Therapy (LI-ESWT) in Patients With Erectile Dysfunction.

Objective: Erectile dysfunction (ED) is a common cause of sexual disorders in men with limited treatment options. This study aimed to determine the efficacy of low-intensity extra corporal shockwave therapy (LI-ESWT) in patients suffering from ED. Materials and methods: A single-group, pre-test, and post-test pre-experimental study were conducted. Thirty-one ED patients were prospectively selected according to the eligibility criteria. In each session, 3000 shocks were applied at 5 points over the penis. Eight sessions were delivered in total with a 2-3-day interval. The patient's condition was assessed using the International Index of Electric Function (IIEF-5) questionnaire at baseline and one month after the last treatment session. Paired t-test was used to determine the difference between the pre-test and post-test. Results: Mean age of the patients was 44.6 (± 14.70) ranging from 25 to 78 years. The majority of them were married (83.9%) and service providers (51.6%). We have also found 51.6% overweight, 9.7% obese, 48.4% diabetic, 45.2% hypertensive, 12.9% with enlarged prostate, 45.2% smoker, 25.8% alcoholic, and 71% with sleep disturbances. During the pre-test, 9.7% had severe ED and 51.6% had moderate ED. After the treatment, no patients were found with severe ED, and few of them had moderate ED (9.7%). The mean difference in IIEF-5 score during the pre-test and post-test was statistically significant (p= < 0.001). Conclusion: The study showed efficacy of LI-ESWT in a subset of patients with ED. Future studies with larger sample size, placebo group, and longer follow-up periods are recommended.

Função intestinal impacta na qualidade de vida e na função sexual de mulheres com endometriose profunda de acordo com o tipo de tratamento? / Does bowel function impacts on quality of life and sexual function in women with deep infiltrating endometriosis according kind of treatment?

ABSTRACT Background: Women with intestinal endometriosis may have a higher incidence of constipation, which may influence their quality of life. Objective: To correlate bowel function with sexual function and quality of life in women with deep endometriosis according to the type of treatment. Methods: Cross-sectional study carried out with 141 women with bowel endometriosis from May 2020 to April 2021. Women were divided into two groups according to kind of treatment: 51 women with surgery treatment and 90 women with medical treatment. The Endometriosis Health Profile Questionnaire were used to assess quality of life e Female Sexual Function Index were used to assess sexual function. To access bowel function we used the following questionnaires: Gastrointestinal Quality of Life Index and Pelvic Floor Distress Inventory. Results: The mean age of women in the surgical group (37.98±5.91years) was higher than that of the medical group (35.68±5.45years) (P=0.006). There was no statistically significant difference between pain symptoms (P=0.905), water intake (P=0.573) or fiber (P=0.173) and physical activity (P=0.792) in both groups. There was no difference between quality of life and sexual function in both groups. There was a direct correlation of bowel function with quality of life and sexual function in both groups. Conclusion: Bowel function is directly correlated with sexual function and quality of life, regardless of the type of treatment.

RESUMO Contexto: Mulheres com endometriose intestinal podem apresentar maior incidência de constipação o que influencia na qualidade de vida. Objetivo: Correlacionar a função intestinal com a função sexual e qualidade de vida de mulheres com endometriose profunda de acordo com o tipo de tratamento. Métodos: Estudo transversal realizado com 141 mulheres com endometriose intestinal no período de maio de 2020 a abril de 2021. As mulheres foram divididas em dois grupos de acordo com o tipo de tratamento: 51 mulheres com tratamento cirúrgico e 90 mulheres com tratamento médico. O Questionário de Qualidade de Vida em Endometriose foi utilizado para avaliar a qualidade de vida e o Índice de Função Sexual Feminina foi utilizado para avaliar a função sexual. Para avaliar a função intestinal foram utilizados os seguintes questionários: Índice de Qualidade de Vida Gastrointestinal e Inventário de Estresse do Assoalho Pélvico. Resultados: A média de idade das mulheres do grupo cirúrgico (37,98±5,91 anos) foi maior que a do grupo médico (35,68±5,45 anos) (P=0,006). Não houve diferença estatisticamente significativa entre sintomas de dor (P=0,905), ingestão de água (P=0,573) ou fibra (P=0,173) e atividade física (P=0,792) em ambos os grupos. Não houve diferença entre qualidade de vida e função sexual em ambos os grupos. Houve uma correlação direta da função intestinal com qualidade de vida e função sexual em ambos os grupos. Conclusão: A função intestinal está diretamente correlacionada com a função sexual e qualidade de vida, independentemente do tipo de tratamento.

Female Sexual Dysfunction in Association with Sexual History, Sexual Abuse and Satisfaction: A Cross-Sectional Study in Hungary.

Female sexual dysfunction (FSD) has a negative impact on women's quality of life, self-esteem, and physical health. The aim of the present study was to explore the prevalence and the factors associated with FSD using an online questionnaire. A cross-sectional survey was conducted among young adults (18-35 years old) in Hungary using the DSM-5 criteria. The participants (n = 5942) were divided into three major groups: FSD (20.3%), an intermediate group (43.9%), and a control group (35.6%). Most of the women showing FSD were affected with female orgasmic disorder (9.2%) and genito-pelvic pain/penetration disorder (4.6%), while female sexual interest/arousal disorder was found in altogether 100 women (1.7%); 4.8% of women were affected by more than one definite disorder. The occurrence of female sexual dysfunction was related to the women's previous sexual history (first sexual experience, sexual education, early encounter with pornographic content, and sexual abuse), their self-satisfaction (with their own body, genitalia, and sexual attraction), and their sexual orientation. Sexual dysfunction showed a strong association with abuse, sexually transmitted diseases, and self-esteem. The present study identified the relationship between sexual dysfunctions and other health conditions, which can be the basis for some form of screening and early assistance programs for FSD.

Sexual dysfunction in men with alcohol dependence.

Background: Prolonged and excessive use of alcohol can affect the sexual function. The occurrence of sexual dysfunction has adverse psychological and interpersonal consequences. Aim: To assess the occurrence and correlates of sexual dysfunction in individuals suffering from alcohol dependence. Materials and Methods: Seventy male subjects hospitalized in a tertiary care hospital for treatment of alcohol dependence syndrome with simple withdrawal symptoms were included in the study with their informed consent. Their sexual function was evaluated utilizing a 14-item changes in sexual functioning questionnaire. Results: According to the findings of the current study, sexual dysfunction is quite prevalent in alcohol-dependent people (75.7%). Erectile dysfunction was the most common disorder, followed by diminished sexual desire and early ejaculation. Conclusion: Alcohol-dependence patients have a high prevalence of sexual dysfunctions. In routine clinical practice, this may be overlooked. Clinicians must be made aware of the frequent occurrence of sexual disorders in alcohol dependence patients.

Reaching consensus: a scoping review on erectile disorder guidelines.

Erectile disorder (ED) is the continuous or repeated inability to achieve an erection or maintain its firmness for an adequate amount of time during sexual intercourse. Given the importance of utilizing quality clinical practice guidelines (CPGs) for the diagnosis of ED, the research team conducted a scoping review of erectile disorder CPGs to address the questions based on the clinical guideline of the best quality. This scoping review was conducted in five steps: 1 - identification of the research question, 2 - identification of relevant studies, 3 - selection of studies, 4 - data extraction, 5 - summarizing and reporting the results. The initial search yielded 1,888 articles, CPGs and books but after primary and secondary screening by two appraisers, 9 CPGs were extracted. After that, the two appraisers examined the quality of these guidelines using the AGREE II tool. Eventually, 5 CPGs extracted. After reviewing 5 guidelines, 5 questions were answered. Overall, the CPGs had desirable overlap in response to the marked questions; nevertheless, there were some differences in details too. This review shows that the first and foremost principle in examining the affected individuals is taking a complete detailed history, followed by a physical examination and use of relevant questionnaires to complete the information necessary to diagnose the problem. The next step is to perform routine lab tests; hormonal profiles may also be checked, and if necessary, special tests should be performed based on an individual's conditions.

Opioid-Induced Sexual Dysfunction in Cancer Patients.

Sexual dysfunction is common in patients with advanced cancer, although it is frequently belittled, and thus consistently underdiagnosed and untreated. Opioid analgesics remain fundamental and are widely used in cancer pain treatment. However, they affect sexual functions primarily due to their action on the hypothalamus-pituitary-gonadal axis. Other mechanisms such as the impact on the central and peripheral nervous systems are also possible. The opioid-induced sexual dysfunction includes erectile dysfunction, lack of desire and arousal, orgasmic disorder, and lowered overall sexual satisfaction. Around half of the individuals taking opioids chronically may be affected by sexual dysfunction. The relative risk of sexual dysfunction in patients on chronic opioid therapy and opioid addicts increased two-fold in a large meta-analysis. Opioids differ in their potential to induce sexual dysfunctions. Partial agonists and short-acting opioids may likely cause sexual dysfunction to a lesser extent. Few pharmaceutical therapies proved effective: testosterone replacement therapy, PDE5 inhibitors, bupropion, trazodone, opioid antagonists, and plant-derived medicines such as Rosa damascena and ginseng. Non-pharmacological options, such as psychosexual or physical therapies, should also be considered. However, the evidence is scarce and projected primarily from non-cancer populations, including opioid addicts. Further research is necessary to explore the problem of sexuality in cancer patients and the role of opioids in inducing sexual dysfunction.

Female sexual dysfunction after bariatric surgery in women with obesity: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: Obesity is prevalent and has a negative impact on women's health, including sexual dysfunction. Recent review articles suggest improvement in Female Sexual Function Index (FSFI) and proportion of female sexual dysfunction (FSD) among women with obesity after bariatric surgery. METHODS: We pooled data from 16 observational studies involving 953 women. The study outcomes were mean FSFI scores and proportion of FSD before and after bariatric surgery. We also sub-analyzed whether age and duration of follow-up affected these outcomes. RESULTS: The mean age of the subjects was 39.4 ± 4.2 years. Body mass index (BMI) showed significant reduction postoperatively (p < 0.0001). Bariatric surgery led to significant improvement in total FSFI score (p = 0.0005), and all sexual domains except pain. Bariatric surgery reduced the odds of having FSD by 76% compared with those who did not undergo operation (OR 0.24, 95% CI = 0.17, 0.33, p < 0.0001). Our sub-analysis demonstrated a significant reduction in the proportion of FSD for patients <40 years of age. The improvement of total FSFI scores and reduction in proportion of FSD remained significant within the first 12 months after surgery. Univariate meta-regression showed that BMI was not a significant covariate for improvement of FSFI scores (ß = 0.395, p = 0.1, 95% CI = 0.884, 0.095). CONCLUSIONS: Bariatric surgery is shown to improve sexual function scores and prevalence of FSD. This is especially significant among women <40 years of age. This benefit remained significant within the first year after surgery. This appears to be an additional benefit for these patients.

For patients with non-obstructive azoospermia, the outcome of testicular sperm extraction correlates with self-esteem, sexual health and the quality of the couple's relationship.

BACKGROUND: A very small number of studies have indicated that azoospermia or negative testicular sperm extraction (TESE) outcomes are linked to depression or erectile dysfunction. However, the data are often weak, conflicting and gathered with non-validated questionnaires. Hence, we performed a cross-sectional study of 44 men with non-obstructive azoospermia. Levels of self-esteem and the quality of the couple's sex life and overall relationship were assessed with validated questionnaires before and after the TESE procedure as a function of the TESE outcome. RESULTS: A positive TESE outcome (n = 24) was associated with a statistically significant increase in self-esteem (particularly with regard to family aspects), sexual health and couples' adjustment quality. In contrast, a negative TESE outcome (n = 20) was associated with statistically significant decreases in self-esteem, erectile function, intercourse satisfaction, orgasmic function, couples' adjustment quality and all aspects of the couple's relationship (consensus, cohesion, satisfaction and affection). CONCLUSION: For men with non-obstructive azoospermia (NOA), negative TESE outcomes may have a negative impact on self-esteem and the quality of the couple's sex life and overall relationship. This should be borne in mind when counselling men with NOA and their partners to (ideally) help them to cope with and decrease the harmful impacts of azoospermia and negative TESE.

RESUME: INTRODUCTION: Quelques études concernant l'azoospermie ou les résultats négatifs de l'extraction de sperme testiculaire (TESE) montrent que ces résultats peuvent être liés à la dépression ou aux dysfonctions érectiles. Cependant, les données sont souvent faibles, contradictoires et recueillies à l'aide de questionnaires non validés. Nous avons donc réalisé une étude transversale auprès de 44 hommes atteints d'azoospermie non obstructive (ANO). Les niveaux d'estime de soi et la qualité de la vie sexuelle du couple et de la relation globale ont été évalués à l'aide de questionnaires validés avant et après la procédure TESE en fonction du résultat de la TESE. RéSULTATS: Un résultat positif de TESE (n = 24) a été associé à une augmentation statistiquement significative de l'estime de soi (en particulier en ce qui concerne les aspects familiaux), de la santé sexuelle et de la qualité de l'adaptation du couple. En revanche, un résultat négatif de TESE (n = 20) a été associé à une diminution statistiquement significative de l'estime de soi, de la fonction érectile, de la satisfaction des rapports sexuels, de la fonction orgasmique, de la qualité de l'adaptation du couple et de tous les aspects de la relation de couple (consensus, cohésion, satisfaction et affection). CONCLUSION: Chez les hommes atteints d'ANO, une TESE négative peut avoir un impact négatif sur l'estime de soi et la qualité de la vie sexuelle et de la relation globale du couple. Il convient de garder cela à l'esprit lors du conseil aux hommes atteints d'ANO et à leurs partenaires afin de les aider (idéalement) à faire face aux impacts néfastes de l'azoospermie et de la TESE négative et à les réduire.

Persistent Genital Arousal Disorder (PGAD): A Clinical Review and Case Series in Support of Multidisciplinary Management.

INTRODUCTION: Persistent genital arousal disorder (PGAD) is an uncommon condition resulting in intrusive, unwanted and distressing symptoms of genital arousal. Presentation can vary and most cases do not have an immediately identifiable etiology. OBJECTIVES: To present evaluation and treatment recommendations for PGAD from a multidisciplinary perspective and provide case examples. METHODS: A focused review of the literature on diagnosis, workup, and treatment of PGAD was completed. A case series of 3 varying presentations of PGAD is offered. RESULTS: PGAD results in high levels of patient distress and is best managed with a multidisciplinary treatment approach. Identification and management of co-occurring symptoms or disease states is imperative, particularly psychologic and psychiatric comorbidities. With appropriate intervention, patients may achieve improvement of their physical symptoms and a decrease in associated psychological distress. CONCLUSION: PGAD is an uncommon and highly distressing condition that requires thoughtful evaluation for appropriate diagnosis and treatment. Multidisciplinary treatment approaches provide the best opportunity to address the needs of patients and optimizing treatment response. Pease ER, Ziegelmann M, Vencill JA, et al. Persistent Genital Arousal Disorder (PGAD): A Clinical Review and Case Series in Support of Multidisciplinary Management. Sex Med Rev 2022;10:53-70.

Sexual Disorders in Women with Overactive Bladder and Urinary Stress Incontinence Compared to Controls: A Prospective Study.

Introduction and Hypothesis Female urinary incontinence (UI) has a negative impact on sexual function and sexual quality of life (QoL) in women. But there is still no consensus on the type of UI or the prevalence of sexual dysfunction (SD). The aim of the study was to evaluate sexual disorders in women with overactive bladder (OAB) compared to patients with urinary stress incontinence (SUI) and healthy controls. Materials and Methods 106 women presenting to a urogynecological outpatient clinic (referral clinic) were investigated using standardized questionnaires and the Female Sexual Function Index (FSFI-d). All 65 incontinent women underwent a full urodynamic examination; the controls (31) were non-incontinent women in the same age range who came for routine check-ups or minor disorders not involving micturition or pelvic floor function. Women with mixed urinary incontinence, a history of previous medical or surgical treatment for UI, recurrent urinary tract infections, previous radiation therapy or pelvic organ prolapse of more than stage 2 on the Pelvic Organ Prolapse Quantification (POP-Q) system were excluded. Results 100 questionnaires could be evaluated (94.3%). Thirty-four women had urinary stress incontinence, 35 had OAB, 31 were controls. Mean age was 56 years, with no significant differences between groups. The scores of the questionnaire ranged from 2 to 35.1 points. The median score of OAB patients was significantly lower (17.6) than the median score of the controls (26.5; p = 0,004). The stress-incontinent women had a score of 21.95, which was lower than that of the controls but statistically non-significant (p = 0.051). In all subdomains, the OAB patients had lower scores than the stress-incontinent women and significantly lower values than the control group. Most striking was the impairment of "sexual interest in the last 4 weeks". The figure for "none or almost no sexual activity" was 80% for the OAB group, 64.7% for the group of stress-incontinent women and 48% for the control group. Incontinence during intercourse was reported by one OAB patient and 4 stress-incontinent women but did not occur in the control group. Conclusions There is a high prevalence of SD in women with urinary incontinence. Patients with OAB reported a greater negative impact on sexual function and had significantly lower scores for the FSFI questionnaire than patients with stress incontinence or controls.

The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD.

INTRODUCTION: The 2 most well-known classification systems that include sexual medicine diagnoses are the International Classification of Diseases and Statistics (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). Sexual medicine experts from international societies representing an array of disciplines have revised and redefined female sexual dysfunctions (FSDs) to reflect current scientific evidence and the state of the art. AIM: To summarize the evidence and interactive and chronological process by which sexual medicine societies' consensus groups developed the current nomenclature, classifications, and definitions for FSDs. METHODS: We review the contributions and collaborations of the Fourth International Consultation in Sexual Medicine (ICSM), the International Society for the Study of Women's Sexual Health (ISSWSH), and the World Association of Sexual Health in conjunction with the World Health Organization. MAIN OUTCOME MEASURES: The ICSM and ISSWSH diagnostic systems are contrasted with the DSM classification. We discuss innovations and strengths; relevant evidence regarding epidemiology, etiology, and risk factors; and key differences. We describe how sexual medicine expertise informed FSD codes in the ICD-11 classification. RESULTS: ICSM and ISSWSH published evidence-based guidelines on the definitions, nomenclature, and diagnostic criteria for FSD that diverge from the DSM psychiatric compendia. These definitions and nomenclature recommend the separation of female sexual desire and arousal disorders, elaborate on subtypes of arousal problems, broaden the scope of sexual pain definitions, and provide a greater understanding of etiologies and risk factors for FSDs. CONCLUSIONS: These collaborations among sexual medicine experts and their role in the ICD-11 development process provide confidence that the ICD-11 Sexual Dysfunction codes are based on current scientific evidence for diagnosing and coding FSDs in clinical settings worldwide, can serve as endpoints in clinical trials, and will provide specificity for treatment outcomes for FSD therapies. Parish SJ, Cottler-Casanova S, Clayton AH, et al. The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD. Sex Med 2021;9:36-56.

Disfunciones y trastornos sexuales en mujeres en climaterio: pacientes del Instituto Nacional de Perinatología / Sexual dysfunctions and disorders in climacteric women: patients from the national institute of perinatology"

La sexualidad es una de las áreas que sufre cambios importantes cuando la mujer se instala en el climaterio, estos cambios se conocen como trastornos y/o disfunciones sexuales. Material y método: en el Instituto Nacional de Perinatología se llevó a cabo un estudio con 139 mujeres en climaterio; se utilizó la encuesta de síntomas y la Historia Clínica Codificada de la Sexualidad Femenina (HCCSF) para conocer la presencia de las disfunciones y/o trastornos sexuales y los factores asociados a estos. Resultados: no se encontró relación alguna entre las variables sociodemográficas y la presencia de disfunciones sexuales; de la muestra, 124 mujeres presentaron al menos una disfunción sexual. Conclusión: aquellas mujeres que cuentan con información sexual a edades tempranas, que tienen deseo y cooperan durante la relación sexual y que además han explorado su sexualidad con más de una pareja, tienen un efecto protector para no presentar disfunciones sexuales. Por otra parte, la presencia de trastornos sexuales se asocia exclusivamente con padecimientos médicos y de salud en la mujer como en la pareja.

Sexuality is one of the areas that undergoes important changes when women settle in climacteric, these changes are known as sexual disorders and/or dysfunctions. Methods: A study was carried out at the National Institute of Perinatology with 139 women in climacteric. The survey of symptoms and the Codified Clinical History of Female Sexuality (HCCSF) were used to determine the presence of sexual dysfunctions and/or disorders and the factors associated with them. Results: No relationship was found between sociodemographic variables and the presence of sexual dysfunctions. Of the sample, 124 women presented at least one sexual dysfunction. Conclusion: Those women who have sexual information at an early age, who have desire and cooperate during sexual intercourse and who have explored their sexuality with more than one partner, have a protective effect for not presenting sexual dysfunctions. On the other hand, the presence of sexual disorders is associated exclusively with medical and health conditions in both the woman and the couple.

Evaluation of the effect of carrot seed (Daucus Carota) in women of fertile age with hypoactive sexual desire disorder: A randomized double-blind clinical trial.

BACKGROUND: Hypoactive Sexual Desire Disorder (HSDD) is a common sexual problem of women which has negative impacts on their health and quality of life. Given the side effects of pharmacologic interventions, it would be beneficial to patients trying to find new options based on herbal medicine. OBJECTIVES: To evaluate efficacy of carrot seed on sexual dysfunction of women with HSDD compared with placebo. METHODS: In this randomized double-blind clinical trial, 68 participants randomly assigned to the intervention group which took 500 mg carrot seed three times a day for 12 weeks versus placebo. Participants in two groups filled Female Sexual Function Index (FSFI) questionnaire at baseline, week six and 12. Repeated measure analysis of variance (ANOVA) test was used for statistical analysis. RESULTS: Thirty women in carrot seed group and thirty women in placebo group completed 12 weeks of the study. In general, carrot seed compared to placebo improved the total score of FSFI 7.329 ± 0.830 (p < 0.001), desire 4.1±0.7 (p < 0.001), lubrication 4.7±0.4 (p = 0.019), arousal 4.1±0.08 (p < 0.001), satisfaction 4.8±1.1 (p < 0.001), orgasm 3.9±0.9 (p < 0.001) and pain 5.4±1(p < 0.001). No adverse event was reported in this study. CONCLUSIONS: Women with HSDD may benefit from six weeks' treatment with carrot seed for improvement of sexual dysfunction. Further large clinical studies are warranted to confirm efficacy of this herbal drug.

Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample.

BACKGROUND: Postorgasmic illness syndrome (POIS) is a rare syndrome of unknown etiology where patients experience distressing physical and psychological after ejaculatory sequelae. AIM: To better characterize the epidemiology, symptomatology, disease course, and treatment of POIS, with specific interest placed on examining relationships between disease presentation and measures of disease burden. METHODS: A 30-item questionnaire was distributed to an online community of patients with POIS from June 2019 to January 2020. We assessed diagnostic criteria and clusters of symptomatology described in prior studies. Outcome measures include self-reported measures of symptom severity, disease burden, and behavioral changes. Statistical correlations were assessed with Pearson's chi-squared (χ2) and ordinal regression analyses. OUTCOMES: The main outcome measures of this study are self-reported measures of symptom severity, disease burden, and behavioral changes. RESULTS: The sample consisted of 302 men (mean age: 32.6 ± 11.4 years, mean age of onset: 19.1 ± 7.8 years) with 89% satisfying ≥3 diagnostic criteria. Common symptoms were difficulty concentrating (254, 84%), extreme fatigue (250, 83%), irritability (225, 74%), and muscle weakness (212, 70%). Common symptom clusters were general (219, 72%), muscle (137, 45%), and head (93, 31%). Common behavioral modifications were avoiding masturbation (215, 71%), schedule changes (213, 71%), and abstinence (186, 62%). Head and throat symptom clusters demonstrated worse disease burden outcomes. Professional medical advice was sought by 51% of participants. Attempted treatments included pharmacotherapy, vitamins, supplements, and herbs with variable efficacy. CLINICAL IMPLICATIONS: This study further characterizes POIS, including how patients respond to the condition, how it is treated in the community, and presentations that may be associated with more severe disease. STRENGTHS & LIMITATIONS: This is the largest study to date that concerns patients suffering from POIS and includes a diverse, global population. Limitations include that the survey was only administered in English and within 1 online community, that results were self-reported, and that the response rate was low (32%). CONCLUSIONS: Characterizing symptom cluster, but not number of diagnostic criteria, may offer prognostic value, and investigation to elucidate pathophysiology and potential treatments for POIS is necessary. Natale C, Gabrielson A, Tue Nguyen HM, et al. Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample. J Sex Med 2020;17:2229-2235.