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Background Duty Sex—the act of engaging in sex out of a sense of duty or obligation to a partner—is a commonly reported reason why women have sex, with studies indicating associations between Duty Sex and sexual dysfunction, as well as nonconsensual sexual experiences (NSEs). Aim This study sought to examine the associations between Duty Sex frequency, sexual function, and NSEs using comprehensive, validated measures of sexual function and NSE histories in a large community sample of women. Methods Six hundred and fifty-eight women with (n  = 293) and without (n  = 365) NSE histories completed measures of sexual function and sexual motivations. Results Women with NSE histories reported more sexual pain, lower sexual satisfaction, and more frequent Duty Sex. The relation between NSE history and Duty Sex remained after controlling for the variance in sexual function. The type of NSE behavior, but not the timing of the first NSE nor the perceived impact of the experience, predicted Duty Sex frequency. Clinical implications Clinicians should consider sexual motivations, particularly Duty Sex, when treating women with NSE histories or who experience sexual dysfunction. Strengths and Limitations To our knowledge, this was the first study to examine how NSEs relate to all domains of sexual function and sexual motives, revealing a link between NSEs, sexual function, and Duty Sex. However, we were unable to account for what percentage of sexual encounters are considered Duty Sex. Therefore, our measurement of Duty Sex lacks specificity, which may explain the relatively low variance accounted for by the models in our analyses. Conclusions There are consequences of NSEs, including difficulties with communicating sexual boundaries and impairment of sexual function, that may contribute to the increased likelihood of engaging in Duty Sex. [ABSTRACT FROM AUTHOR]

Penile erection (PE) is a hemodynamic event that results from a neuroendocrine process, and it is influenced by the cardiovascular status of the patient. However, it may also modulate an individual's cardiovascular events. The present study provides the mechanisms involved in the association of PE and cardiovascular function. Erection upsurges the cardiac rate, blood pressure, and oxygen uptake. Sex-enhancing strategies, such as phosphodiesterase inhibitors, alprostadil, and testosterone also promote vasodilatation and cardiac performance, thus preventing myocardial infarction. More so, drugs that are used in the treatment of hypertensive heart diseases (such as angiotensin system inhibitors and β-blockers) facilitate vasodilatation and PE. These associations have been linked with nitric oxide- and testosterone-dependent enhancing effects on the vascular endothelium. In addition, impaired cardiovascular function may negatively impact PE; therefore, impaired PE may be a pointer to cardiovascular pathology. Hence, evaluation of the cardiovascular status of an individual with erectile dysfunction (ED) is essential. Also, employing strategies that are used in maintaining optimal cardiac function may be useful in the management of ED. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer survivors can experience vaginal length shortening, vaginal stenosis, vaginal elasticity deterioration, sexual frequency reduction and sexual dysfunction. This prospective, uncontrolled, monocentric clinical interventional study aimed to evaluate the effect of vaginal dilation therapy on vaginal condition and sexual function of cervical cancer survivors who had not received timely vaginal dilation. Methods: A total of 139 patients completed the study. They received 6 months of vaginal dilation therapy. We evaluated their vaginal elasticity, vaginal diameter, vaginal length and sexual function before and after vaginal dilation therapy. Their vaginal conditions were evaluated by customised vaginal moulds, and the sexual function was assessed by female sexual function index. The SPSS 25 software was used to analyse all the data. Results: Age, vaginal diameter and sexual intercourse frequency before diagnosis were significantly associated with female sexual dysfunction of the patients after cancer treatment. Vaginal dilation therapy improved vaginal stenosis, vaginal length and sexual function in all the patients; however, the vaginal elasticity and incidence of sexual dysfunction did not improve significantly. Sexual intercourse frequency before diagnosis, vaginal elasticity, time interval from last treatment and treatment modalities were significantly associated with the change in female sexual function index score before and after vaginal dilation therapy. Patients with a time interval from the last treatment less than 24 months or those who had moderate or good vaginal elasticity, benefitted more from vaginal dilatation therapy. Conclusions: cervical cancer survivors who had not received timely vaginal dilation still benefitted from vaginal dilation therapy, irrespective of the treatment methods they received. Moreover, vaginal dilation therapy should be performed as early as possible after cervical cancer treatment. [ABSTRACT FROM AUTHOR]

Background: Poor glycemic control and sexual dysfunction have been shown to impair health-related quality of life (HRQoL) of individuals with diabetes. However, mediators underlying this relationship have not been evaluated. This study aimed/sought to assess the effect of fasting blood glucose (FBG) and peripheral arterial disease (PAD) on the relationship between sexual functioning (SeF) and HRQoL among Nigerians with type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study consecutively recruited 210 participants diagnosed with T2DM. The recent FBG and lipid profiles were gleaned from the medical records of the participants. We assessed the ankle-brachial index by 8 MHz handheld vascular Doppler. Participants completed the Changes in Sexual Functioning Questionnaire and Short Form 12 (SF-12) questionnaire to assess SeF and HRQoL, respectively. Results: Significant differences exist in HRQoL of participants with good and poor glycemic control (mean rank = 111.02 vs. 93.64, p = 0.035) but none between participants with and without PAD (mean rank = 101.39 vs. 107.60, p = 0.483). There was a significant correlation between SeF and HRQoL (r = 0.181, CI = 0.043–0.313, p = 0.008), and a significant negative correlation between HRQoL and FBG (r = -0.149, CI = -0.284 - -0.008, p = 0.033). There is a significant indirect effect of impact of SeF on HRQoL through FBG (b = -0.027, t = -0.899) and PAD (b = 0.034, t = 1.246). Furthermore, the direct effect of SeF on HRQoL in the presence of the mediators was also significant (b = 0.483, p = 0.001). This shows that PAD and FBG mediates the relationship between SeF and HRQoL. Conclusion: Good glycemic control and the absence of PAD mediate the relationship between SeF and HRQoL in Nigerians with T2DM. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Cognitive models of sexual dysfunction situate distraction as a core mechanism underlying difficulties with sexual function. It follows that individuals who have difficulties with inattention and distractibility (e.g., attention-deficit/hyperactivity disorder; ADHD) may be at increased risk of problems with their sexual function, though previous research is mixed, and no research has examined links with sexual distress despite distress being a necessary criterion for sexual dysfunction. The goals of the current study were to: (1) examine associations between ADHD symptoms, sexual function, and sexual distress; (2) examine group differences in sexual function and sexual distress as a function of presumptive ADHD diagnosis; and (3) establish whether individuals with presumptive ADHD are at greater risk of distressing problems with sexual function relative to controls. In a large mixed-gender community sample (N = 943: controls n = 837, presumptive ADHD n = 106), we found that ADHD symptoms were positively correlated with worse overall sexual function, as well as orgasm difficulties and greater sexual distress. Relative to controls, individuals with presumptive ADHD reported worse sexual function and greater sexual distress, controlling for age, biological sex, and sexual orientation. Individuals with presumptive ADHD were significantly more likely (OR = 2.16) to have distressing problems with sexual function than controls. Core difficulties related to ADHD, including inattention, distractibility, and emotion dysregulation, may make individuals more vulnerable to experiencing problems with sexual function and sexual distress, putting them at risk for developing sexual dysfunction. Taken together, these data support associations between ADHD and distressing sexual function problems, including possible mechanisms explaining these links such as difficulties with emotion regulation. [ABSTRACT FROM AUTHOR]

Aim: To compare opioid use disorder (OUD) patients who continue to use opioids and are in remission with buprenorphine‐naloxone (B/N) in terms of some parameters and to evaluate the relationship between B/N dose and these parameters. Method: We included 141 OUD patients in remission with B/N maintenance treatment for at least 6 months, 141 who still used opioids, and 141 healthy volunteers. Substance Craving Scale (SCS), Pittsburgh Sleep Quality Index (PSQI), Arizona Sexual Experiences Scale (ASEX), and Short Form 36 (SF‐36) were administered. Results: PSQI scores and ASEX scores were higher in those who continued to use opiates than in OUD in remission, and in OUD in remission compared to controls. OUD patients with current opioid use also had lower SF‐36 scores compared to both patients in remission and healthy controls. SCS, PSQI, ASEX, and SF‐36 scores were similar when the three groups were examined based on the dosage of B/N (below 8, 8–15, and 16 mg/day and above) use in OUD in remission. Conclusions: Quality of life, craving, sleep and sexual functions improved significantly with B/N; however, these effects are not dependent on B/N dosage. [ABSTRACT FROM AUTHOR]

Background Sexual interest/arousal disorder (SIAD) is one of the most common sexual problems for women. In clinical research, there are often misalignments between the research priorities of patients and researchers, which can negatively impact care, and gender-diverse individuals are often excluded from research. Inclusion of patient perspectives when establishing research priorities may help to reduce these gaps; however, the research priorities of couples coping with SIAD remain unclear. Aim Identify the research priorities of women and gender-diverse individuals with SIAD and their partners. Methods In an online survey, couples coping with SIAD provided consent and responded to an open-ended question asking them to list the top 3 things they think are important for researchers to focus on related to couples coping with low sexual desire. A team-based content analysis was conducted to identify themes and their frequency of endorsement. Outcomes An author-developed open-ended question. Results Analysis of 1279 responses (n  = 667 from women and gender-diverse individuals with SIAD, n =  612 from partners) resulted in our identification of 6 main themes: general causes, general treatment and coping, biophysiological, relationship, psychological, and environmental/contextual. Additionally, we identified 4 sub-themes within each of the latter 4 main themes: general, cause, treatment, and impact. For women and gender-diverse individuals with SIAD, their partners, and specifically gender-diverse participants, the 3 most endorsed themes were psychological general factors (24.3%, 21.2%, 24.3%; eg, stress and the link between SIAD and anxiety), relationship general factors (15.7%, 13.2%, 18.6%; eg, relationship length and communication on sexual desire), and biophysiological general factors (12.3%, 12.4%, 14.3%; eg, research on medications and hormones). Clinical Implications Clinical researchers should consider the research priorities of couples coping with SIAD to ensure their work aligns with the needs of the affected population. Strengths and Limitations This study is the first to identify the research priorities of both women and gender-diverse individuals with SIAD and their partners. Most participants identified as heterosexual, North American, and of middle to high socioeconomic status; results may not generalize. Responses were sometimes brief and/or vague; interpretation of these responses was therefore limited and may have required more contextual information. Conclusion Findings suggest that women and gender-diverse individuals with SIAD, their partners, and gender-diverse participants have similar research priorities that are consistent with a biopsychosocial approach to research. Heterogeneity of responses across themes supports a multidisciplinary, patient-oriented approach to SIAD research. [ABSTRACT FROM AUTHOR]

Background: Sexual satisfaction is an important component of global quality life for many adult men. Substantial gaps exist in our appreciation of how age mediates sexual satisfaction in the context of functional sexual measures. We sought to evaluate modifiable factors associated with overall sexual satisfaction and health‐related quality of life (HRQoL) in a large, age‐stratified community‐based sample of adult men. Methods: A sample of adult males registered with the online research service ResearchMatch completed a 75‐item online questionnaire in this cross‐sectional study. Queries included demographics, general health data, and validated sexual health measures including International Index of Erectile Function‐5 (IIEF‐5) and Premature Ejaculation Diagnostic Tool (PEDT). Multivariable regression was performed to assess associations with self‐reported sexual satisfaction (defined by "moderately satisfied" or "very satisfied" on the 5‐level Likert scale) and overall HRQoL (as measured by the EQ‐5D‐visual analog scale (VAS) stratified by age. Results: One thousand thirty‐three men completed the survey and were stratified by age cohorts. IIEF‐5 and PEDT scores were higher in younger cohorts. On multivariable regression analysis, higher IIEF‐5, lower PEDT, better overall health‐related quality of life, and the presence of a sexual partner within the last month were associated with an increased likelihood of overall sexual satisfaction. When stratified by age cohort, higher IIEF‐5 scores were consistently positively associated with sexual satisfaction (Odds Ratio (OR) 1.18, 95% CI 1.15–1.22, P < 0.001), as well as independently associated with improved overall HRQoL by EQ‐5D‐VAS (β = 0.71, Standard Error (SE) = 0.08, P < 0.001). Conclusions: The erectile function was independently associated with sexual satisfaction and quality of life across all age strata and predictive of both sexual satisfaction and global HRQoL. Low overall rates of sexual satisfaction across cohorts highlight the critical importance of evaluation and treatment of sexual health, regardless of age. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Methods Results Conclusion Implications for Practice Reporting Method Patients or Public Contribution To evaluate the psychometric properties of the Chinese version of the Vulvovaginal Symptoms Questionnaire for assessing vulvovaginal symptoms and symptom‐related influences in women with breast cancer.A methodological study.Women with breast cancer (n = 202) were recruited from the outpatient department of a hospital. Data were collected between July 2020 and October 2021. Psychometric properties, including internal consistency, test–retest reliability and construct validity, were tested after the translation of the original English‐language instrument. The construct validity was examined by testing the hypothesised relationships between the Chinese version of the Vulvovaginal Symptoms Questionnaire with validated instruments associated with quality of life and sexual function and by Confirmatory Factor Analysis.The internal consistency and test–retest reliability for the Chinese version of the Vulvovaginal Symptoms Questionnaire's total scale and four subscales were satisfactory. The construct validity was confirmed by significant correlations between scores on the Chinese version of the Vulvovaginal Symptoms Questionnaire with the Chinese version of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire‐Cancer 30 and Quality of Life Questionnaire‐Breast 23 and the Chinese version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire 12. The Confirmatory Factor Analysis verification results showed that the traditional Chinese‐language questionnaire's three‐ and four‐factor models had acceptable model fit indices.We obtained the Chinese version of the Vulvovaginal Symptoms Questionnaire's preliminary and satisfactory psychometric properties. It can help worldwide healthcare professionals adequately assess vulvovaginal symptoms and their influences experienced by Chinese‐speaking women with breast cancer.The Chinese version of the Vulvovaginal Symptoms Questionnaire can help healthcare professionals and researchers concurrently identify vulvovaginal symptoms and related influences, leading to timely and appropriate management. Well‐designed and accessible healthcare services on vulvovaginal and sexual health after breast cancer diagnosis are essential for both healthcare professionals and this population.We adhered to the STROBE checklist of cross‐sectional studies.No patient or public engagement.. [ABSTRACT FROM AUTHOR]

Background: Pulmonary arterial hypertension (PAH) can have several consequences on sexual function, which can lead to worsened quality of life. Aim: The study sought to assess sexual function and its association with health functionality and quality of life in females with PAH. Methods: A descriptive cross-sectional study was carried out in pulmonary circulation outpatient clinics from January 2022 to March 2023 in females diagnosed with pulmonary hypertension. Assessment was carried out through the application of the Female Sexual Function Index, the 36-item World Health Organization Disability Assessment Schedule, and the Medical Outcome Study 36-Item Short Form Survey. Outcomes: Data were analyzed using SPSS version 22.0 and JASP, and Spearman's correlation tests were applied between the instruments, with a P value <.05 considered significant. Results: A total of 91 females were assessed. It was identified that 90.1% of females had sexual dysfunction, with worse scores in females with sexual dysfunction in the domains of satisfaction, arousal, and desire, with average health functionality and quality of life. There were significant correlations between the domains of mobility, getting along, life activities, and the overall functionality score with some domains of sexual function, especially arousal and satisfaction. We found significant correlations between some domains of quality-of-life assessment with the domains of desire, arousal, and satisfaction, and with the overall score of sexual function assessment, as well as strong correlations between health functionality and quality of life. Clinical Implication: The data reinforce the need for rehabilitation programs and social support for this population. Strengths and Limitations: This is one of the few studies to evaluate sexual function, quality of life, and health functionality in women with PAH. Due to limitations in data collection, we were unable to assess certain factors such as hormone levels and a history of sexual abuse. Conclusion: We identified a high prevalence of sexual dysfunction in females with PAH with mild functional impairment and a moderate quality-of-life score with correlations between sexual function, health functionality, and quality of life. [ABSTRACT FROM AUTHOR]

Background: Research has shown that negative sexual attitudes are associated with lower levels of sexual functioning among men and women, however, little is known about how attitudes about mothers as sexual beings are associated with sexual functioning for parents. Aim: The aim of the current study was to examine how attitudes toward mothers as sexual beings (ATMSB) were associated with sexual functioning for women and partners of women among parents with young children. Methods: Cross-sectional retrospective data were collected online via Qualtrics Panels from 475 women and men (partnered to women) who reported having their first child within the last 5 years. Outcomes: The Revised Female Sexual Function Index and revised Expanded Prostate Cancer Index Composite–Short Form were used to measure sexual function in women and men, respectively. Results: Results indicated that after controlling for age and relationship length, more positive ATMSB predicted higher levels of sexual functioning (and multiple domains of functioning) for men and women. Clinical Implications: These findings indicate that sexual functioning, especially in parents, is linked to the attitudes held toward seeing mothers as inherently sexual (or not). Strengths and Limitations: This is the first study to examine how attitudes toward mothers as sexual beings can impact sexual functioning, though the cis heterosexual mostly white sample is a notable limitation. Conclusion: ATMSB may need to be examined and challenged in the context of treating sexual dysfunction during this transitional period for mothers and those partnered to mothers. [ABSTRACT FROM AUTHOR]

Introduction: Overactive bladder (OAB) is a syndrome of the lower urinary tract characterized by urinary urgency, frequency, and nocturia, with or without urgency urinary incontinence. OAB significantly impacts all aspects of life—social, psychological, physical, professional, domestic, and sexual—for both women and men. The aim of this study was to investigate sexual dysfunction in both women and men with OAB treated with intravesical onabotulinumtoxinA (Botox) injections using the Sexual Quality of Life questionnaire in two versions: female (SQoL-F) and male (SQoL-M). Methods: Forty sexually active patients (thirty women and ten men) with idiopathic OAB were recruited. Patients completed the SQoL-F or SQoL-M questionnaire before treatment, and again at 3 and 6 months after treatment with intravesical onabotulinumtoxinA injections. Results: All 40 patients completed the study (30 women and 10 men). There were no statistically significant differences in SQoL results before the procedure or at 3- and 6-months post-treatment. Conclusions: OAB treatment with onabotulinumtoxinA did not significantly affect the quality of sexual life in either women or men. Further research is needed using questionnaires specifically designed to assess the sexual life of patients with OAB, especially in men. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the prevalence of deep and superficial dyspareunia in women with diagnosis of endometriosis. Secondly, to assess the temporal relation between deep and superficial dyspareunia in women reporting both symptoms (concomitant dyspareunia) and the impact on quality of life (QoL) and sexual function. Methods: This is a cross-sectional cohort study that included fertile women with diagnosis of endometriosis. Enrolled subjects reported pain symptoms including dyspareunia and its temporal onset and completed two one-time validated questionnaires regarding sexual function (Female Sexual Function Index) and QoL (International QoL Assessment SF-36). Results: Among the 334 enrolled patients, 75.7% (95%) reported dyspareunia. Women were divided into four groups according to the presence and type of dyspareunia: isolated superficial dyspareunia (6.3%), isolated deep dyspareunia (26.0%), concomitant dyspareunia (43.4%) and no dyspareunia (24.3%). Women with concomitant dyspareunia reported higher NRS scores than women with isolated dyspareunia or no dyspareunia (P ≤ 0.001). The majority of women with concomitant dyspareunia (56.6%) reported that deep dyspareunia developed before superficial dyspareunia. Women with concomitant dyspareunia reported worse QoL and worse sexual function than women with isolated dyspareunia or without dyspareunia (P ≤ 0.001). Conclusion: Dyspareunia is a common symptom in women with endometriosis, with many reporting concomitant deep and superficial dyspareunia. Concomitant dyspareunia can significantly impact sexual function and quality of life (QoL). Therefore, it is crucial to investigate dyspareunia thoroughly and differentiate between its types to tailor effective therapeutic strategies. [ABSTRACT FROM AUTHOR]

This study aimed to investigate health-related quality of life (HRQoL), sexual function, psychological-health, reproductive concerns, and fertility outcomes of women of reproductive age undergoing Fertility-Sparing Surgery (FSS) for treatment of ovarian cancer (OC) or borderline ovarian tumor (BOT), over a 2-year period. Prospective longitudinal multicentre study including women 18–40 years undergoing FSS between 2016 and 2018 in Sweden. Clinical data at diagnosis, histopathological findings and 2-year follow-up regarding oncological and reproductive outcomes were collected. Participants completed the EORTC QLQ-C30 and OV-28, FSFI, HADS and study-specific items at time of diagnosis and at one- and two-years following FSS. Data were analysed using a model for repeated measures to investigate changes over time. Of 68 eligible women, 49 were included following exclusions due to benign pathology or subsequent radical surgery. During a mean follow-up of 20.5 months, two women experienced a recurrence and 82% reported regular menstruations. The majority (94%) had a strong desire to become biological mothers, which remained or increased over time. The conception-rate was 76%. HRQoL, psychological-health and sexual function improved over time and the proportion of women with sexual dysfunction decreased. At one-year follow-up 50% of nulliparous women had scores indicating sexual dysfunction compared to 0% of the women who had given birth either before or after surgery (p = 0.008). HRQoL, psychological-health and sexual function improved during two-year follow-up after FSS in young women presenting with OC or BOT. Women who had given birth prior to or after FSS reported improved sexual function compared to nulliparous women. • Quality of life and sexual function improved over time in women undergoing fertility-sparing surgery for ovarian tumors. • Young women undergoing fertility-sparing surgery for ovarian tumors expressed a strong desire to become biological mothers. • Giving birth had a positive effect on sexual function in women undergoing fertility-sparing surgery for ovarian tumors. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: Male sexual function is an important aspect of the life of prostate cancer patients and plays a significant role in the long-term quality of life of prostate cancer survivors. However, there is a paucity of published literature on the perceived impact of prostate cancer and its treatment on the sexual function of patients in Ghana and West Africa in general. The purpose of this study was to explore the perceptions of prostate cancer patients on the effects of the disease and radiation therapy on male sexual function. The study also examined the changes in sexuality experienced by men with prostate cancer. Methods: This research was a descriptive longitudinal study conducted at the third largest hospital in Africa. The study included Ghanaian prostate cancer patients of all ages who were treated with definitive radiotherapy at the study site between October 2021 and May 2022. Quantitative data were collected and analysed using the Statistical Package for Social Sciences version 26.0 and Microsoft Excel 2019. Descriptive statistics were used to determine frequencies and percentages of the demographic characteristics. Results: The mean age of the participants was 65.7 years (SD 6.7) ranging from 50 to 81 years. Patients had different ideas about the potential adverse effects of prostate cancer (86%) and radiotherapy (70%) on male sexual function. A decrease in sexual desire (54%) was the commonest perceived effect of prostate cancer on male sexual function followed by premature ejaculation (49%) and a decrease in sexual activity (48%). On the other hand, erectile dysfunction (49%) was the commonest perceived effect of radiotherapy for prostate cancer on male sexual function followed by a decrease in sexual desire (38%) and premature ejaculation (37%). Health professionals were the major source of information regarding the perceptions of the patients on the effects of both prostate cancer (46%) and radiation therapy (43%) on male sexual function. Conclusion: There should be enhancement of awareness measures to educate Ghanaian cancer patients on the side effects and implications of treatment on their sexuality. Comprehensive sexual health assessment should be incorporated in the routine care of patients with cancers that have the potential to impact the sexual function of patients. [ABSTRACT FROM AUTHOR]

• cGVHD patients with higher IL-8, MIP-1α, and MIF had more depression, anxiety, fatigue, insomnia, and sexual dysfunction. • Actigraphy-derived circadian rest-activity indices had few associations with behavioral symptoms in cGVHD patients. Chronic graft-versus-host disease (cGVHD) is a complication of allogeneic hematopoietic cell transplant (HCT) and is associated with morbidity and high symptom burden. This study evaluated two biobehavioral mechanisms, inflammation and circadian rest-activity rhythms, that may underly commonly reported psychological and physical symptoms in cGVHD patients. Adults with cGVHD (N =57) wore a wrist actigraph for 7 days, provided a blood sample, and completed patient-reported outcome (PRO) measures. 24-hour rest-activity indices were derived from actigraphy. Cytokines and chemokines relevant to cGVHD were measured in peripheral blood plasma using multi-analyte immunoassays. Multiple regression evaluated the extent to which rest-activity indices and inflammatory biomarkers predicted PROs. Higher levels of circulating IL-8 and MIP-1α were associated with worse depression (β = 0.35, p = 0.01; β = 0.33, p = 0.02) and sexual function (β = -0.41, p = 0.01; β = -0.32, p = 0.03). MIP-1α was associated with more severe insomnia (β = 0.36, p = 0.01). Higher circulating MIF was associated with more severe anxiety (β = 0.28, p = 0.048) and fatigue (β = 0.35, p = 0.02). Il-6, TNFα, and MCP-1 showed few associations with PROs. There were few associations between actigraphy indices and PROs; however, participants with a later daily activity peak (acrophase) reported poorer sexual function (β = -0.31, p = 0.04). Models covarying for age, cGVHD severity, and time since HCT yielded a similar pattern of results. Results suggest that pro-inflammatory cytokines and chemokines associated with cGVHD may contribute to PROs, identifying a biobehavioral mechanism that may be a useful target for future interventions. [ABSTRACT FROM AUTHOR]

Background: Methadone-induced sexual dysfunction in men can significantly impair their quality of life and reduce methadone adherence, thereby interfering with its therapeutic benefits. Objectives: This study aimed to compare the effects of bupropion and amantadine on reducing sexual dysfunction in methadone-dependent males. Methods: This clinical trial included 47 methadone-dependent males attending the Addiction Treatment Center in Babol, Iran. Participants were randomly assigned to either the amantadine group (n = 23) or the bupropion group (n = 24). Demographic data and addiction history were collected using a checklist, and sexual dysfunction was assessed with the International Index of Erectile Function (IIEF) Questionnaire before and after the intervention. Paired t-tests, independent t-tests, and chi-squared tests were used to compare the two groups. Results: Both groups had similar demographic variables and sexual function scores before the intervention (P > 0.05). However, there was a significant difference between the two groups in terms of total sexual dysfunction scores (52.13 ± 13.07 for bupropion vs. 60.79 ± 4.47 for amantadine; P = 0.006). Additionally, significant differences were observed in sexual desire (P = 0.003), satisfaction with intercourse (P = 0.001), and overall satisfaction (P = 0.034), with higher scores in the bupropion group. Adverse medication-related effects were less prevalent in the bupropion group (54.2%) compared to the amantadine group (60.9%). Conclusions: Bupropion appears to be more effective in improving sexual function in methadone-dependent males undergoing methadone treatment, with patients in the bupropion group achieving better scores than those in the amantadine group. Additionally, the occurrence of adverse effects was lower in the bupropion group compared to the amantadine group. [ABSTRACT FROM AUTHOR]

Background and Objectives: Sexual function is an important part of the life of postmenopausal women with type 2 diabetes and changes in it, especially in menopause, can affect their health. The sexual function of these women can be affected by various factors. The purpose of the present study was to investigate the mediating role of distress tolerance in the relationship between anxiety and depression and sexual function in postmenopausal women with type 2 diabetes. Materials and Methods: The present research is descriptive. The statistical population in this research included postmenopausal women with type 2 diabetes in Tehran City in 2023. A sample size of 300 people was selected based on Kline model and by convenience sampling. Data collection tools included Isidori's Female Sexual Function Index, Beck's Depression Inventory-II, Beck's Anxiety Inventory, and Simons and Gaher's Distress Tolerance Scale. The data were analyzed using structural equations modelling. Results: The findings showed that the direct effects of anxiety, depression, and distress tolerance on sexual function were significant (p=0.001). Also, the results showed that distress tolerance has a mediating role in the relationship between anxiety and depression and sexual function. Conclusion: According to the results of the current study, sexual function of postmenopausal women with type 2 diabetes can be affected by anxiety, depression, and distress tolerance. It is concluded that anxiety and depression affect the distress tolerance and cause defects in the sexual function of postmenopausal women with type 2 diabetes; so it is suggested to reduce their anxiety and depression in psychological interventions for these women. [ABSTRACT FROM AUTHOR]

Male hypogonadism, which is characterized by low testosterone levels, has a significant impact on male sexual function, overall health, and fertility. Testosterone replacement therapy (TRT) is the conventional treatment for this condition, but it has potential adverse effects and is not suitable for men seeking to conceive. Testosterone plays an essential role in male sexual function, metabolism, mood, and overall well-being. Clomiphene citrate, a drug originally developed for female infertility, has recently gained attention as an off-label treatment for male hypogonadism. By blocking the negative feedback of estrogen on the hypothalamus and pituitary glands, clomiphene stimulates gonadotropin secretion, leading to increased endogenous testosterone production, which, in turn, improves sperm parameters and fertility and alleviates the symptoms of hypogonadism. Regarding the safety profile of clomiphene compared with TRT, clomiphene appears to confer a lower risk than TRT, which is associated with adverse effects such as polycythemia. Furthermore, combination therapy with clomiphene and anastrozole or human chorionic gonadotropin has been investigated as a potential approach to enhancing the effectiveness of treatments for improving hypogonadism symptoms. In conclusion, clomiphene citrate may offer a promising alternative to TRT for men with hypogonadism, particularly those desiring fertility preservations. However, its long-term efficacy and safety remain inadequately understood. Future research should focus on exploring the benefits of combination therapies and personalized treatment strategies based on individual patient characteristics. [ABSTRACT FROM AUTHOR]

Introduction: Suburban population is increasingly growing in Iran. People in the suburbs usually have limited sexual information and there are limited studies into their sexual issues. This study aims the effect of sexual education (SE) based on the Sexual Health Model (SHM) on sexual functioning among women living in the suburbs. Methods: This is a randomized controlled trial with two parallel groups. Seventy-six women will be selected through simple random sampling from healthcare centers in suburban areas and will be allocated to a control group (n = 38) and an intervention group (n = 38) with a randomization ratio of 1:1. Participants in the intervention group will receive SHM-based SE in three120 min weekly sessions which will be held using the lecture, question-and-answer, group discussion, and educational booklet methods. Data will be collected through a demographic and midwifery characteristics questionnaire, the Female Sexual Function Index, the Depression Anxiety Stress Scale, and the Sexual Quality of Life-Female, and will be analyzed through the analysis of covariance as well as the independent-sample t, the paired-sample t, and the Chi-square tests. Discussion: We hope this study provides a clear framework for decision-makers and healthcare providers to provide appropriate policies and interventions for SE and thereby improve the sexual health of women in the suburbs. Trial registration: This study was registered in the Iranian Registry of Clinical Trials on 2024.03.05 (code: IRCT20231121060133N1). [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to determine the effect of WhatsApp-based BETTER sex counselling on sexual function and sexual quality of life in breast cancer survivors in a randomized control trial. Methods: This is a randomized controlled trial in which a total of 90 breast cancer survivors were recruited using convenience sampling and then randomly assigned to two groups of WhatsApp-based BETTER model counselling and routine care. Data collection tools consisted of a demographic questionnaire, the Sexual Quality of Life-Female (SQOL-F) and the Sexual Function Index (FSFI-BC). Participants in the intervention group were given access to the 6-week program. The program consisted of six consultation and assignment packages covering all six steps of the BETTER model. Data were analyzed using SPSS software version 20. Chi-square test, independent samples t-test and repeated measures analysis of variance were used. The significance level (p-value) was considered to be less than 0.05. Results: In the control group, the mean score of SQL scale changed from 35.16 ± 10.71 to 35.16 ± 12.97 (P > 0.05) and in the intervention group, it significantly increased from 34.76 ± 10.13 to 68.20 ± 20.48 (P < 0.001). Similarly, the comparison of mean of FSF in the control group showed a none-significant change from 58.13 ± 7.11 to 58.35 ± 6.11 (P > 0.05), and in the intervention group, it significantly improved from 59.49 ± 6.10 to 120.73 ± 25.54 (P < 0.001). The results of rANOVA indicated that there was a significant difference in the mean scores of the SQL and SFS between the two groups from pre- to post-intervention, and then over the 1-month follow-up period in the intervention group (p < 0.001). Considering partial eta squared, the effect of the intervention had the highest interaction effect on both variables of the sexual function index (η2 = 0.73) and sexual quality of life (η2 = 0.41). Conclusions: The intervention program was a successful model for improving female sexual quality of life and female sexual function in breast cancer survivors. Trial registration: IRCT20210926052601N1, 7–11-2021. [ABSTRACT FROM AUTHOR]

Purpose: The current study sought to evaluate the sexual function of transgender men and women and to identify associated factors. Methods: Trans individuals who were outpatients at our gender incongruence (GI) center for follow-up of gender-affirming hormone therapy with age ranging 27 to 50 years were invited to participate in this cross-sectional study. Clinical data were collected from the medical records. Two scales, the Female Sexual Function Index (FSFI) and the Male Sexual Function Index (MSFI), were administered to all females (n = 50) and all males (n = 58). Each participant also responded to a semi-structured questionnaire that assessed feelings regarding being transgender and satisfaction with sexual life. Results: Relative to trans women, trans men had a higher total FSFI score, and higher scores in the FSFI domains of arousal, lubrication, orgasm, and satisfaction (all p < 0.01), and in the total MSFI score, and higher scores in the MFSI domains of arousal, erection, orgasm, and satisfaction (all p < 0.01). A separate semi-structured evaluation indicated that more than half of the trans men and almost half of the trans women were satisfied or very satisfied with their sexual life. Conclusions: The total scores from the FSFI and MSFI indicated a high risk of sexual dysfunction in trans men and especially, in trans women. However, the semi-structured evaluation showed that more than half of the trans men and almost half of the trans women were satisfied with their sexual life. [ABSTRACT FROM AUTHOR]

People living with chronic primary or secondary musculoskeletal pain conditions such as low back pain, fibromyalgia, and inflammatory arthritis typically experience wide-ranging impacts on their physical function, activity participation, and psychosocial wellbeing. These can extend to negative impacts on a person's sexual function and their intimate relationships. While sexual function is an important component of wellbeing, it is often not considered within musculoskeletal pain care. Without awareness or targeted training, physical therapists may lack the confidence and skills to screen, assess, and manage the impacts that pain may be having on a person's sexual function and can miss the opportunity to tailor their care and optimize wellbeing. This article seeks to raise awareness among physical therapists of how living with chronic musculoskeletal pain can impact a person's sexual function and intimate relationships, and provide guidance on how to consider these issues within a person-centered approach to care. It describes why considering sexual function and intimate relationship issues as part of a person's lived musculoskeletal pain experience may be relevant, outlines the use of validated patient-reported outcome measures to assess sexual dysfunction, and suggests practical strategies for sensitively raising sexual function in consultations. Management approaches and possible referral pathways are also presented, to assist physical therapists in understanding available care options. This article seeks to support holistic care by improving physical therapists' knowledge and understanding of sexual dysfunction and its management in people living with chronic musculoskeletal pain. Impact Considering sexual function as a valued functional activity, together with other activities of daily living, will assist physical therapists to provide more holistic and person-centered care. This article covers the main considerations for raising sexual function and intimate relationship issues with people living with chronic musculoskeletal pain, as well as management options and potential referral pathways. Physical therapists are encouraged to seek targeted training to improve their confidence and skills in this area, and to use inclusive, respectful language for discussions around sexual function and intimate relationships. [ABSTRACT FROM AUTHOR]

Aim: Sexual dysfunction is an important, and often overlooked, sequela of rectal cancer treatment with significant implications for patients' quality of life. The aim of this study was to explore patients' information needs regarding sexual health after rectal cancer treatment and their experiences accessing information on sexual dysfunction throughout the cancer care continuum. The secondary aim was to explore surgeons' perspectives on patients' information needs and gain insight into their experiences providing information on sexual health following rectal cancer surgery. Method: A qualitative study was conducted using semistructured interviews with 10 rectal cancer survivors and six colorectal surgeons from a Canadian tertiary care institution. Transcribed interviews were coded independently by two researchers and thematic analysis was performed. Results: Analysis of patient interviews revealed that patients had limited knowledge of sexual dysfunction symptoms following rectal cancer treatment and received inadequate information on sexual dysfunction from their treating medical team. Patients expressed the desire to receive information on sexual dysfunction in different formats, especially before the start of treatment. The surgeon interviews revealed that colorectal surgeons faced challenges when informing patients about sexual dysfunction. Surgeons did not routinely provide information on sexual dysfunction to all patients; however, they felt that patients should receive high‐quality information on sexual dysfunction, both before and after treatment. Conclusion: Patients' information needs related to sexual dysfunction after rectal cancer treatment were inadequately met. High‐quality informational resources are needed to facilitate communication between patients and physicians and improve patients' understanding of sexual dysfunction. [ABSTRACT FROM AUTHOR]

Breast cancer is especially prevalent among women. It can affect patients' sexual function, body image, and marital relations. The aim of present study was to investigate the relationship between body image and sexual function among women with breast cancer. This case–control study was done online on patients admitted to the clinic of breast cancer in 2021 in Jahrom, Iran. The sample consisted of 222 women (111 with breast cancer who had undergone mastectomy and 111 without breast cancer). To collect data, two questionnaires, female sexual function index and body image scale, were used. p < 0.05 was significant. Sexual dysfunction among women with breast cancer was 91%. The most common disorder was sexual arousal. Comparing sexual domains: desires disorder (OR: 3.11, 95% CI: 1.63–5.49), arousal disorder (3.31, 95% CI: 1.16–9.45), orgasm (OR: 4.08, 95% CI: 1.57–10.55), vaginal lubrication (OR: 2.68, 95% CI: 1.06–6.76), sexual satisfaction (OR: 2.65, 95% CI: 1.11–6.36), and painful intercourse (OR = 2.03 95% CI = 0.95–4.35) saw a decrease in the women with breast cancer group compared to the control group. The body image concern among women with breast cancer (51.56 ± 15.09) compared to the control (45.80 ± 16.82) was significant (OR = OR: 2.66, 95% CI: 1.22–5.81). Women with breast cancer undergo problems in sexuality and are afraid of their body image. Moreover, there is a correlation between sexuality and body image. Therefore, it is necessary to inform patients about the effects of treatments and the side effects of breast cancer on sexuality. Sexual dysfunctions are highly prevalent among women with breast cancer, and have been associated with body image. This study examined the relationship between body image and sexual function among women with breast cancer. Orgasm and libido, lubrication, and satisfaction decrease in women with breast cancer compared to healthy women. [ABSTRACT FROM AUTHOR]

Background: Female cancer survivors often experience estrogen-deprivation symptoms, which may lead to decreases in sexual desire, vulvovaginal health (lubrication, dryness, discomfort), and sexual satisfaction. Interventions are needed to address these concerns. Aim: The objective of this secondary analysis was to determine if women with higher (better) scores on the Female Sexual Function Index (FSFI) lubrication and pain subscales reported higher desire scores based on treatment with bupropion vs placebo. Methods: Participants were part of NRG Oncology's NRG-CC004 (NCT03180294), a randomized placebo-controlled clinical trial evaluating bupropion (150 vs 300 mg) to improve sexual desire in survivors of breast or gynecologic cancer. All participants with baseline data from the FSFI lubrication, pain, and desire subscales with 5- and/or 9-week data were analyzed. The FSFI subscale scores were correlated using Spearman correlation coefficients. Logistic regression was used to determine associations between FSFI desire and other FSFI subscales while accounting for treatment arm and other covariates. Outcomes: The primary outcome of NRG Oncology's NRG-CC004 (NCT03180294) randomized phase II dose-finding trial was change from baseline to 9 weeks on the FSFI desire subscale score. Similar to the parent study, the primary outcome for this ancillary data study was the FSFI desire subscale score at 5 and 9 weeks. Results: Overall, 230 participants completed the FSFI at baseline and 189 at 9 weeks. The strongest correlations were between lubrication and pain at baseline (all participants, rho = 0.77; bupropion arms, rho = 0.82), week 5 (all participants, rho = 0.71; bupropion arms, rho = 0.68), and week 9 (all participants, rho = 0.75; bupropion arms, rho = 0.78), and the weakest correlations were between desire and pain. In patients in the treatment arms there were no interactions between lubrication or pain. The impact of various covariates on the FSFI score for desire at 9 weeks demonstrated that participants of non-White race (odds ratio [OR], 0.42; 95% CI, 0.21-0.81; P = .010), with a high lubrication score (OR, 0.36; 95% CI, 0.21-0.61; P = .0002), with a high pain score (less pain) (OR, 0.50; 95% CI, 0.29-0.87; P = .014), or with prior pelvic surgery (OR, 0.38; 95% CI, 0.23-0.63; P = .0002) had lower odds of having low desire. Clinical Implications: Acute estrogen-deprivation symptoms should be addressed prior to sexual desire intervention. Strengths and Limitations: This secondary analysis was not powered to examine all variables. Conclusion: Lubrication and pain were predictors of low desire. Therefore, vulvovaginal atrophy and associated genitourinary symptoms of menopause such as vaginal dryness and dyspareunia should be addressed prior to or in parallel with interventions for sexual desire. [ABSTRACT FROM AUTHOR]

Simple Summary: Patients diagnosed with gynecological and breast cancer undergo multimodal treatments leading to estrogen deprivation and vaginal damage in case of radiotherapy, resulting in significant impairments of vulvo-vaginal function. Non-ablative intravaginal CO2 laser is a promising technique for VVA (vulvo-vaginal atrophy) in breast cancer, gynecological and other pelvic cancer survivors. In this study we explored the effectiveness and the long-term effects of repeated cycles of laser therapy. This therapeutic regimen could represent an effective treatment option for patients with limited therapeutic alternatives due to the hormone-sensitivity frequently showed by these cancers. This study aimed to investigate the efficacy and duration of multiple non-ablative intravaginal CO2 laser (V-lase®) cycles in breast cancer patients, gynecological and other pelvic cancers previously subjected to multiple oncological treatments. This prospective study enrolled women under the age of 65 years who reported vaginal symptoms. Data on the Vaginal Health Index (VHI), vaginal length (VL), vaginal pain measured using a Visual Analog Scale (VAS), and the Female Sexual Function Index (FSFI) were collected at baseline and before each laser application, and at subsequent follow-up visits. A total of 170 laser applications were performed on 113 women with various types of cancer. Most patients (57.5%) had received radiotherapy-based treatments before receiving laser treatment. Vaginal health parameters and sexual function improved significantly with each laser application. However, a temporary decline in these improvements occurred during the intervals between cycles. Such worsening was reversed with the subsequent cycle in all groups of patients, irrespective of the type of oncological treatments they had undergone. Multiple course vaginal laser therapy showed promising results as a potential treatment for vaginal atrophy in heavily treated gynecological and breast cancer patients, necessitating further research to determine the optimal time interval between cycles to ensure sustained positive effects. [ABSTRACT FROM AUTHOR]

We aimed to establish the prevalence of atypical masturbation in the general population and explore the association between atypical masturbation and male sexual dysfunction in heterosexual males. Atypical masturbation refers to stimulation significantly distinct from that encountered during partnered sexual activity. We posted questionnaires that contained the abridged International Index of Erectile Function (IIEF-6) and the premature ejaculation diagnostic tool on social media in China. We collected 2743 valid questionnaires from December 9, 2020, to April 18, 2021. We found that the prevalence of atypical masturbation in the general population was 10.97%. Men with atypical masturbation had lower IIEF-6 scores and higher rates of erectile dysfunction (ED) than men with typical masturbation. The prevalence of premature ejaculation and estimated intravaginal ejaculatory latency time were not significantly different among men with different patterns of masturbation. Our study demonstrated that atypical masturbation is associated with ED, and a clinician dealing with sexual issues should inquire more fully about masturbation patterns than has been done to date. [ABSTRACT FROM AUTHOR]

Background: Multiple Sclerosis (MS) a central nervous system autoimmune disorder, mainly affecting young adults and more prevalent among women, can lead to sexual dysfunction (SD) among both males and females with MS. Female sexual dysfunction can be defined as dyspareunia, a lack of sexual desire, disorders in the arousal and orgasm phases, and sexual pain disorders. The purpose of this study is to investigate the changes in sexual function among females with MS whose treatment was switched from first-line injectable medications to other agents after a six-month duration. And assess the changes in all three domains of SD. Methods: In this longitudinal study females diagnosed with MS, aged between 18 and 50 years old, and were candidates for switching their treatment from interferon beta-1a (intra-muscular and subcutaneous), and Glatiramer Acetate (GA), to Fingolimod, Dimethyl Fumarate (DMF), or Natalizumab (NTZ) due to patients' convenience and tolerability and adverse events were included. "Multiple Sclerosis Intimacy and Sexuality Questionnaire-19" was used to evaluate the SD changes before and six months after the new treatment initiation. Statistical analysis was conducted using SPSS V.24 software. Histograms and the Shapiro-Wilk test were used to assess the normality of the variables; due to the non-normal distribution of quantitative variables (except for age), the Wilcoxon signed-rank test was used to compare the scores, before and six months after the medication change. The level of significance was considered less than 0.05. Results: Out of 107 female participants (average age: 35.09 ± 5.61), The mean of overall MSISQ-19 scores, before and six months after the medication change were not significant (p-value = 0.091). However, considering the subdomains, the medication changes only affected the tertiary subdomain of MSISQ-19 (p-value = 0.017). Still, the scores of other subdomains did not change significantly (p-value = 0.761 for primary SD and 0.479 for secondary SD). Also, there wasn't any significant difference between EDSS before and after the medication change (p-value = 0.461). Conclusions: To our knowledge, this was the first study, assessing the effect of MS medication change on the improvement of SD among patients. According to the results of the presented cross-sectional study, we found that during a six-month period, the tertiary subdomain of MSISQ-19 symptoms improved significantly, while the changes in other SD domains were not significant. [ABSTRACT FROM AUTHOR]

Background: Limited gender-based research has compared sexual health among pornography users (PUs) and non-users, including non-problematic pornography users (non-PPUs) and problematic pornography users (PPUs), particularly in non-Western cultures. Methods: A 2022 cross-sectional study involving 450 Iranian university students categorized participants as PUs or non-users based on 12 months of use. PUs were further classified as non-PPUs or PPUs using the 'Problematic Pornography Use Scale' cutoff point, with comparisons of demographic and sexual variables made between these groups. Results: Pornography use was reported among 39.6% of students, including 51.7% of men and 33.6% of women. In general, 9.5% of participants were PPUs, including 17.4% of men and 5.6% of women. PUs were mainly men, had fewer children, shorter marriages, lower religiosity, and lower levels of education. Compared with non-users, PUs reported earlier sexual relationships, lower satisfaction with sex frequency and communication, and greater rates of extramarital relationships, masturbation, sexual desire, and sexual distress. PPUs reported more sexual desire, pornography use, masturbation, and extramarital affairs than non-PPUs. Similar patterns in demographics, sexual history, and health were observed in pornography use across genders. The regression indicated being male (OR: 2.42, 95% CI: 1.44–4.06), having lower education (OR: 0.89, 95% CI: 0.81–0.97), fewer children (OR: 0.64, 95% CI: 0.48–0.86), higher masturbation (OR: 1.31, 95% CI: 1.14–1.49), more extramarital relationship (OR: 1.69, 95% CI: 1.07–2.67), less religiosity (OR: 0.87, 95% CI: 0.82–0.93), more sexual excitement (OR: 0.79, 95% CI:0.62–1), and more sexual distress (OR: 1.20, 95% CI: 1.02–1.32) were associated with pornography use. Two-way ANOVA found no significant effects of gender or pornography use on sexual satisfaction. Women had worse sexual function regardless of usage. Pornography users, regardless of gender, experienced higher sexual distress. [ABSTRACT FROM AUTHOR]

AbstractSexual health difficulties have been associated with frequent effects of various chronic conditions and their symptoms, including fatigue. How these difficulties can be influenced by Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a currently under researched area. This scoping review was conducted using multiple databases to search for any existing literature that examined sexual function and ME/CFS. Out of 380 identified studies, 8 of them meet the eligibility criteria for inclusion. Studies are scarce and further research is needed to assess the effect that fatigue causes on physical, psychological, and emotional areas of sexual experiences and function in people with ME/CFS. [ABSTRACT FROM AUTHOR]

Background/aim: This study describes ventral-approach augmented nontransected anastomotic (vANTA) urethroplasty and presents the preliminary functional results of patients treated with this technique. Materials and methods: Twenty-three patients who underwent vANTA urethroplasty were included in the study. Stricture location, stricture length, preoperative uroflowmetry parameters (maximum flow rate (Qmax) and mean flow rate (Qmean)), preoperative International Index of Erectile Function (IIEF)-5 scores, operation time, postoperative complications, length of hospital stay, and follow-up periods were recorded. The Qmax, Qmean, and IIEF-5 scores of the patients were recorded again in the second and twelfth postoperative months. Preoperative and postoperative Qmax values and IIEF-5 scores were compared. Kaplan-Meier survival analysis was performed to demonstrate recurrence-free survival. Results: The mean age of the patients included in the study was 52.1 ± 16.9 years. Mean stricture length was 2.5 ± 0.5 cm. There was a statistically significant difference between preoperative and 2-month postoperative uroflowmetry Qmax values (6.9 (0.0-14.5) vs. 18.5 (5.5-41.5) mL/s; p < 0.001). There was no statistically significant difference in preoperative and 2-month postoperative IIEF-5 scores (p > 0.05). There was a statistically significant difference between preoperative and 1-year postoperative median Qmax values (7.2 (0.0-12.3) vs. 17.4 (11.2-24.3) mL/s; p = 0.001). There was no statistically significant difference between preoperative and 1-year postoperative IIEF-5 scores (p > 0.05). According to Kaplan-Meier recurrence-free survival analysis, the recurrence-free survival rate at 6 months was 95.7% Conclusion: In cases of bulbar urethral strictures, vANTA urethroplasty is an effective treatment option with limited postoperative complications. Preserving the underlying corpus spongiosum is important to avoid impaired sexual function. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Knowledge of clitoral neuroanatomy is critical to vulvar surgery. We sought to characterize the density and distribution of autonomic and somatic nerves supplying the clitoris. Methods: Pelvic tissue harvested from female cadavers was sectioned axially at three anatomic levels: the proximal aspect of the clitoral body (CB), the distal CB, and the glans. The CB, glans, and the surrounding connective tissue (dorsal, lateral, and ventral) were outlined microscopically. An area containing large nerve bundles dorsal to the CB, referred to as the dorsal nerve subregion, was analyzed separately. Double-immunofluorescent staining for beta III tubulin (βIIIT), a global axonal marker, and myelin basic protein (MBP), a myelinated nerve marker, was performed. Threshold-based automatic image-segmentation distinguished stained areas. Autonomic and somatic density were calculated as percentage of tissue stained with βIIIT alone, and βIIIT and MBP respectively. Comparisons were made using nonparametric Friedman tests. Results: Seven cadavers, aged 22–81, were examined. Somatic (mean 4.42%, SD ± 1.97) and autonomic (2.14% ± 2.42) nerve density was highest in the dorsal nerve subregion and dorsal region at the distal CB level. Compared with the CB, somatic density was higher in proximal (0.05% ± 0.03 vs 1.27% ± 0.69, p = 0.03) and distal (0.29% ± 0.25 vs 1.09% ± 0.41, p = 0.05) dorsal regions. Somatic density was greater in the glans than in the surrounding lateral (0.78% ± 0.47 vs 0.43% ± 0.23, p = 0.03) and ventral (0.78% ± 0.47 vs 0.52% ± 0.2, p = 0.03) regions. Autonomic density was greater than somatic in all areas, except for the dorsal nerve subregion. Conclusions: Somatic and autonomic nerve density were greatest in a well-defined region dorsal to the CB. Surgical preservation of this region is critical for maintaining nerve supply to the clitoris. [ABSTRACT FROM AUTHOR]

Objective: Vulvar lichen sclerosus (VLS) is an underestimated chronic disease. It can cause significant symptom burden and sexual dysfunction. This study aimed to evaluate patient satisfaction and current challenges in the management of VLS in a certified dysplasia unit, particularly during the COVID-19 pandemic. Methods: This survey analyzed patients who had been diagnosed with VLS and treated at our DKG-certified dysplasia unit. The study was conducted during the COVID-19 pandemic in the Department of Gynecology and Obstetrics at the University of Aachen. The questionnaire contained 43 questions on general treatment, diagnostic delays, disease education, psychologic and sexual issues, and specific questions regarding the COVID-19 pandemic. The questionnaires were distributed between January 2021 and September 2023. Results: This study included 103 patients diagnosed with VLS, who were treated at our certified dysplasia unit. Overall, 48% of the patients were satisfied with the success of the therapy. Most participants reported psychologic problems (36.8%), fear of cancer (53.3%), or sexual restrictions (53.3%). Among the patients, 38% were bothered by the regular application of topical cortisone. However, 72% were willing to undergo treatment for more than 24 months. The COVID-19 outbreak in March 2020 had a significant negative impact on general VLS care from the patient's perspective (3.83/5 before vs. 3.67/5 after; p = 0.046). There was a general request for booklets to inform and educate the patients about their disease. Furthermore, the respondents demanded a telephone hotline to answer the questions and wished for follow-up visits via e-mail to cope better with their current situation. Conclusion: This study highlights the need for more effective treatments for VLS and an increased awareness of psychologic and sexual distress. To ensure patient well-being and satisfaction, it is imperative to offer individualized care with adequate disease education in a team of specialists from various disciplines. [ABSTRACT FROM AUTHOR]

• 20 % of males with cystic fibrosis have erectile dysfunction, which alters their quality of life. • 30 % of females with cystic fibrosis have sexual dysfunction. • Faecal incontinence increases the prevalence of sexual dysfunction in females and the severity of erectile dysfunction in males. Sexual dysfunction (erectile dysfunction in males, sexual dissatisfaction, sexual interest/arousal disorders, and dyspareunia in females) has not been the subject of indepth research in people with cystic fibrosis (CF). This study aimed to determine the prevalence of sexual dysfunction in adults with CF, factors associated with sexual dysfunction, and the impact of sexual dysfunction on quality of life. We conducted a multicentre study in adults with cystic fibrosis followed in specialist centres in Western France. We assessed erectile dysfunction and its severity using the IIEF5 self-questionnaire (International Index of Erectile Function); the FSFI (Female Sexual Function Index) was used to assess sexual function in females, and we evaluated quality of life in both sexes using the CFQ-R14+ questionnaire. In total, 77 males and 74 females completed the sexual function questionnaire (mean age 32+/- 10 and 25+/- 8,5 years respectively). Among them, 21 % of males and 30 % of females reported sexual dysfunction. CFQ-R14+ score was significantly lower in males with erectile dysfunction than those without (p < 0.001). Faecal incontinence was associated with more frequent sexual dysfunction in females and higher severity of erectile dysfunction in males. The prevalence of sexual disorders is relatively high in males and females with cystic fibrosis. Therefore, it seems important to train specialist teams to address the issue of sexuality without embarrassment, and to encourage them to seek out and treat faecal incontinence, which is associated with greater severity or frequency of these symptoms. [ABSTRACT FROM AUTHOR]

Background and Objectives: Sexual relationship between couples is an important aspect, with one of its most crucial functions being the creation of intimacy and strengthening emotional relationships between spouses. The present study aimed to determine the moderating role of marital intimacy in the relationship between perceived stress and sexual function of men. Materials and Methods: This is a descriptive-correlation study in which structural equation modeling method is used. The statistical population included Iranian married men aged 25 to 45 residing in Tehran and Isfahan Provinces in 2023 who had been living together for at least one year. Among them, a total of 204 individuals were selected using convenience sampling method. In this study, tools such as the Cohen's Perceived Stress Scale, Rosen's Male Sexual Function Questionnaire, and Walker & Thompson's Intimacy Questionnaire were used. The data was analyzed using Spearman's correlation test and path analysis, and with the use of a moderation model. Results: The findings indicated a significant negative relationship between perceived stress and sexual function of men (β=-0.45, p<0.001). Additionally, marital intimacy showed a significant positive relationship with sexual function of men (β=0.53, p<0.001). Ultimately, marital intimacy played a moderating role in the relationship between perceived stress and sexual function of men (β=0.31, p<0.001). Conclusion: Based on the findings of the current research, it can be concluded that perceived stresses have undesirable effects such as reducing sexual function in the relationship between spouses, and considering psychological variables such as marital intimacy can be effective in education and therapy. [ABSTRACT FROM AUTHOR]

Background: Genital self-image is among the factors affecting women's sexual function. Aim: The present study aimed to determine changes in the genital self-image and its relationship with women's sexual function in the third trimester of pregnancy and postpartum. Methods: The participants of this prospective cohort study included 301 eligible pregnant women chosen through stratified random sampling with proportional allocation from comprehensive health centers in Gorgan, Iran. The Persian version of the 7-item Female Genital Self-Image Scale, the 6-item Female Sexual Function Index, and Depression Anxiety and Stress Scale 21 were filled in a self-report manner on 2 occasions: (1) 30 to 37 weeks of pregnancy and (2) 12 to 16 weeks (± 2 weeks) postpartum. Finally, the data were analyzed using SPSS 24 software. Outcomes: Outcomes included Female Genital Self-Image Scale and Female Sexual Function Index changes from pregnancy to postpartum according to the childbirth mode. Results: The mean age of participants was 29.66 ± 5.27 years. These values for the genital self-image scores of women during pregnancy (19.18 ± 3.25) and postpartum (19.43 ± 3.57) were not significantly different (P = .30). Also, this difference was not statistically significant regarding the mode of delivery in 2 groups of women with vaginal birth (P = .62) and cesarean section (P = .14). The mean Female Sexual Function Index scores during pregnancy (15.15 ± 6.73) and postpartum (17.52 ± 6.46) were significantly different (P = .001). In addition, this difference was significant in women with vaginal birth (P = .004) and cesarean section (P = .001). Clinical Implications: Clinicians should inform women/couples about changes in female sexual function and address genital self-image as a factor involved in female sexual function during pregnancy and postpartum. Strengths and Limitations: Because the participants of this study were women in the third trimester of pregnancy, the obtained results may not be generalized to pregnant women in the first and second trimesters of pregnancy or even to different postpartum periods (ie, midterm and long term). Conclusion: The results showed that the female genital self-image is not significantly different during pregnancy and postpartum, or with the mode of delivery. However, the female sexual function score in postpartum is higher than in pregnancy, regardless of the mode of delivery. [ABSTRACT FROM AUTHOR]

• MRKH patients experience postoperative psychological and sexual distress. • Higher incidence of postoperative depression and anxiety symptoms in MRKH patients. • The FSFI scores were positively associated with self-esteem and negatively with depression and anxiety scores. • The patient's sexual arousal increased significantly with time after surgery. The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare condition with significant psychological implications. However, our understanding of its impact on postoperative sexual function and mental health is still limited. Evaluate the mental health status and sexual functioning of women with MRKH syndrome after vaginoplasty surgery. We enrolled 53 cases with MRKH syndrome who underwent artificial vaginoplasty. The participants were asked to participate in a two-round survey conducted between February 2021 during the covid-19 period and March 2023. The survey included questionnaires to measure depression, anxiety, self-esteem, and sexual functioning. Differences between scores over time were analysed using a paired sample t -test, and we assessed the correlation between mental health and sexual functioning. In the first round, patients' mean ± SD age at surgery was 23.6 ± 4.5 years old, and the mean ± SD time that had elapsed since surgery at the time of the survey was 34.2 ± 20.8 months. None of the patients reported low self-esteem, 45.3 % reported mild-to-moderate depression, and 34.0 % reported mild anxiety. Thirty patients have had vaginal intercourse during the last six months. The mean ± SD Female Sexual Functioning Index score was 24.6 ± 4.4, and 60.0 % had a score of 23.5 or higher, indicating high sexual functioning. The sexual functioning scores were positively correlated with self-esteem scores and negatively correlated with depression or anxiety scores (p < 0.05). There was no significant improvement in patient's mental health status and sexual function between the second round survey (71.3 ± 17.8 months after surgery) and the first round survey (p > 0.05). In contrast, the sexual arousal of FSFI were significantly higher in the second survey round (p < 0.05). Most patients undergoing vaginoplasty reported persisting mental health challenges. However, the majority reported good sexual functioning. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the effect of an intervention based on the theory of planned behavior on sexual function and satisfaction of migrant women during menopause in Iran. Methods: This quasi-experimental study was conducted on 88 migrant and menopausal women in Iran. Sampling was performed using the multistage methods in four health care centers. The educational program based on the theory of planned behavior was held in 4 sessions of 90 min for 4 weeks in the intervention group. The final evaluation of the intervention was performed immediately, and the follow-up stage (3 months after the intervention) by completing questionnaires in two groups. The data was analyzed with SPSS 20 software with statistical tests of mean and standard deviation, Manwitney, Frideman, Generalized Estimating Equations. Results: The results showed that after the intervention, the mean score of sexual function in the intervention group increased from 16.53 ± 2.68 before to 17.52 ± 2.90 immediately and 17.38 ± 2.81 in follow up stage (p < 0.05). But in the control group, this score was not statistically significant during the study stages (p > 0.05). Conclusion: The results indicate that the intervention based on the theory of planned behavior is effective in sexual function and satisfaction with the married life of migrant women during menopause. but to change the sexual function, studies with a longer duration and also the use of other educational models are suggested. [ABSTRACT FROM AUTHOR]

Background: Sexual function plays a very important role in the sexual health of people, and the determination of their related factors reflects the importance of paying attention to sexual function in the cultural context. Objective: The present study aimed to the role of sexual self-esteem, sexual desire, and sexual assertiveness in the female sexual function. Methods: In this descriptive-analytical cross-sectional study, 592 married women of reproductive age referring to comprehensive health centers in Rasht city (North of Iran) and eligible for the inclusion criteria were selected by cluster random sampling. The data collection tools were demographic information form, Halbert's Sexual Rights Questionnaires, Women's Sexual Self-Esteem (short form), Halbert's Sexual Desire, and Female Sexual Function Index. Data analysis was done with descriptive and inferential statistical tests at a significant level (p < 0.05). Results: The mean and standard deviation of sexual assertiveness, sexual desire, and sexual self-esteem scores were 56.79 ± 18.24, 49.12 ± 26.04, and 98.52 ± 6.11, respectively. Sexual assertiveness (p < 0.01, r = 0.13), sexual desire (p < 0.001, r = 0.178), sexual self-esteem (p < 0.01, r = 0.34) of the participants with the total score, and all areas of female sexual function had a significant positive correlation. Conclusion: Based on the findings, there is a direct and statistically significant relationship between sexual assertiveness, sexual desire, the adaptability of sexual self-esteem, and family income with sexual function in participants. However, the unemployment of the spouse had a negative effect on the female sexual function. [ABSTRACT FROM AUTHOR]

Introduction: Sexual problems are prevalent problems among women that affect different aspects of their lives. Counseling in the early stages can solve many of their problems. Therefore, this study aimed to investigate the effect of group counseling based on reality therapy on female sexual function. Methods: The present clinical trial study with a control group was conducted in Arak City in 2016. A total of 40 women were selected from five healthcare centers according to the inclusion and exclusion criteria and were randomly divided into two groups experimental and control. The experimental group received counseling sessions of reality therapy (8 sessions, each 90 minutes, twice a week), and the control group received no intervention. Data collected included demographics and the Female Sexual Function Index (FSFI) questionnaire, completed before and four weeks after the intervention. Results: The mean scores for sexual function in intervention and control groups were 28.63 ± 2.21 and 27.14 ± 2.58 before the counseling, showing no significant differences between the two groups (P = 0.5). But after reality therapy, the values significantly changed in the intervention group (30.29 ± 2.92 vs. 27.64 ± 2.58) (P < 0.05). Conclusions: Counseling based on reality therapy was found effective in improving sexual function in women. Therefore, it is recommended that this method be used in healthcare centers. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: Transgender and gender-diverse people often experience discrimination or even outright exclusion when undergoing medical attention. It has been shown that gender-affirming treatments improve quality of life in transgender patients, and genital-affirming surgery (GAS) is increasingly spreading worldwide. Sexual function after male-to-female GAS has long been evaluated by using tools designed for assigned female at birth (AFAB), resulting in suboptimal assessments. Currently, the operated Male to Female Sexual Function Index (oMtFSFI) is the only validated questionnaire to assess the sexual function of operated transgender women. The current study was aimed at performing cross-cultural adaptation and to test the face validity of the Chilean version of the oMtFSFI. Methods: We carried out an observational descriptive study. The questionnaire was translated into Spanish, adapted, and face validated in five phases with eight participants. The study was approved by the Universidad del Desarrollo Scientific Ethics Committee. Results: According to participants, the questionnaire was shown to both pertinently and exhaustively evaluate the sexual function of post-feminizing genitoplasty transgender women. The questionnaire was well understood by the participants, except for a difficulty in understanding certain terms. Some participants criticized the perspective of the instrument in terms of the assumption of having a partner or having penetrative intercourse via the neovagina. The amendments to the Italian version of the questionnaire were discussed until an agreement on adaptation considering the patient´s perspective was reached. The present preliminary data support the face validity of the Chilean version of the oMtFSFI in the assessment of sexual function in operated transgender women. Conclusions: This adapted questionnaire could be a valuable tool for clinicians and researchers. [ABSTRACT FROM AUTHOR]

This review aimed to investigate the effect of mindfulness-based cognitive therapy (MBCT) on sexual performance and sexual self-efficacy of postpartum women. A comprehensive literature search was conducted using electronic databases, including PubMed, Cochrane Library, PsycINFO, Scopus, Web of Science and Google Scholar to identify relevant studies published between 2016 and 2023. The quality assessment of the selected studies was performed using the Critical Appraisal Skills Program (CASP) tool. Data extraction and synthesis were conducted to summarize the results of the included studies. A total of 12 studies were included in this systematic review. The studies selected for this review were interventional (n = 9) and review studies (n = 3). Quality assessment in most studies showed medium to high quality. The results demonstrated that MBCT interventions have a positive effect on the sexual performance and sexual self-efficacy of postpartum women. Improvements in libido, arousal, psychosis, orgasm and overall sexual satisfaction were reported after MBCT intervention. Moreover, the interventions increased postpartum women's self-efficacy in sexual relationships and communication. The results also showed that MBCT interventions have a promising effect on improving sexual performance and sexual self-efficacy in postpartum women. Incorporating MBCT into postpartum care may help address the sexual health concerns that this population faces. [ABSTRACT FROM AUTHOR]

Background: Despite several treatments that have been used for women reporting vaginal laxity (VL), to our knowledge no systematic review is available on the topic so far. Aim: In this study, we sought to summarize the best available evidence about the efficacy and safety of interventions for treating VL, whether conservative or surgical. Methods: A comprehensive search strategy was performed in Medline, Embase, Scopus, Web of Science, and Cochrane Library for reports of clinical trials published from database inception to September 2022. Studies selected for inclusion were in the English language and were performed to investigate any type of treatment for VL, with or without a comparator, whether nonrandomized studies or randomized controlled trials (RCTs). Case reports and studies without a clear definition of VL were excluded. Outcomes: The outcomes were interventions (laser, radiofrequency, surgery, and topical treatment), adverse effects, sexual function, pelvic floor muscle (PFM) strength, and improvement of VL by the VL questionnaire (VLQ). Results: From 816 records, 38 studies remained in the final analysis. Laser and radiofrequency (RF) were the energy-based treatment devices most frequently studied. Pooled data from eight observational studies have shown improved sexual function assessed by a Female Sexual Function Index score mean difference (MD) of 6.51 (95% CI, 5.61-7.42; i2 = 85%, P < .01) before and after intervention, whether by RF (MD, 6.00; 95% CI, 4.26-7.73; i2 = 80%; P < .001) or laser (MD, 6.83; 95% CI, 5.01-8.65; i2 = 92%; P < .01). However, this finding was not shown when only 3 RCTs were included, even when separated by type of intervention (RF or laser). When RF treatment was compared to sham controls, VLQ scores did not improve (MD, 1.01; 95% CI, −0.38 to 2.40; i2 = 94%; P < .001). Patient PFM strength improved after interventions were performed (MD, 4.22; 95% CI, 1.02-7.42; i2 = 77%; P < .001). The ROBINS-I (Risk Of Bias In Nonrandomized Studies of Interventions) tool classified all non-RCTs at serious risk of bias, except for 1 study, and the risk of bias—1 analysis found a low and unclear risk of bias for all RCTs. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) certainty of the evidence was moderate for sexual function and the VLQ questionnaire and low for PFM strength. Clinical Implications: Sexual function in women with VL who underwent RF and laser treatment improved in observational studies but not in RCTs. Improvement in PFM strength was observed in women with VL after the intervention. Strengths and Limitations: Crucial issues were raised for the understanding of VL, such as lack of standardization of the definition and for the development of future prospective studies. A limitation of the study was that the heterogeneity of the interventions and different follow-up periods did not make it possible to pool all available data. Conclusions: Vaginal tightening did not improve sensation in women with VL after intervention, whereas RF and laser improved sexual function in women with VL according to data from observational studies, but not from RCTs. PFM strength was improved after intervention in women with VL. [ABSTRACT FROM AUTHOR]

Background and Objectives Pregnancy is associated with many physical and mental changes. These changes can lead to sexual dysfunction. Targeted and appropriate training can be effective in reducing this disorder. Therefore, the present study was conducted to determine the effect of sexual health empowerment based on the James Brown model on the sexual function of pregnant women. Subjects and Methods This study was a randomized controlled field trial conducted on 68 pregnant women referring to health centers in 2018. The women were placed in intervention and control groups. The intervention group attended 4 training sessions based on the James Brown model. Evaluation of sexual function before, two weeks and one month after the intervention was done with the FSFI tool. Data analysis was done in SPSS software (version 20), using independent t-tests, paired t-tests, analysis of variance, Wilcoxon, Mann-Whitney and Friedman, chi-square and Fisher's exact tests. P values of less than 0.05 were considered statistically significant. Results Before the intervention, the mean and standard deviation of the sexual function score of pregnant women in the two groups were homogeneous based on independent t-test (P=0.081). Statistical analysis revealed a significant difference (p < 0.001) in total sexual function scores between the intervention and control groups at both two weeks and one month post-intervention. Conclusion Sexual health education based on the James Brown model has a positive effect on the sexual function of pregnant women. Therefore, by training based on this model, it is possible to increase awareness and then improve the sexual function of pregnant women. [ABSTRACT FROM AUTHOR]

Background: Radical hysterectomy (RH) is commonly used to treat early-stage cervical cancer in women of childbearing age and sexual dysfunction due to postoperative vaginal shortening is a major concern. The impact of intraoperative vaginoplasty on prognosis and quality of sexual life in patients with early-stage cervical cancer remains controversial and lacks high-level evidence. However, there are few reports on vaginoplasty after RH to lengthen vagina in patients. This prospective, multi-center, randomized controlled trial aims to explore the impact of peritoneal vaginoplasty with or without ovarian transposition after laparoscopic RH on sexual dysfunction in patients with early-stage cervical cancer. Methods: Eligible patients will be randomly assigned (1:1) to receive peritoneal vaginoplasty or not. The primary evaluation indicators are female sexual function index (FSFI) and male sexual satisfaction scale. The secondary evaluation indicators include EORTC QLQ-CX24, 2-year overall survival (OS), 5-year OS, 2-year progression-free survival (PFS), 5-year PFS and surgery-related complications. The trial will enroll 368 patients from 6 hospitals in China over a 3-year period and follow up for 5 years. [ABSTRACT FROM AUTHOR]

Introduction: Sexual function of patients with endometriosis should be assessed by patient‐reported outcome measures (PROMs) that present high reliability and validity. The objective was to study the PROMs used to assess sexual function for patients with endometriosis to improve their selection for research and clinical practice. Material and methods: We performed a systematic literature review from January 2000 to September 2023. All studies including women with confirmed endometriosis and assessing sexual quality of life or sexual function or sexual distress were retrieved. Different properties of PROMs used for sexual dysfunction were assessed according to the COnsensus‐based Standards for the selection of health Measurement Instruments (COSMIN) recommendations. Properties evaluated were: structural validity, internal consistency, cross‐cultural validity, reliability, measurement error, criterion validity, construct validity, and responsiveness. This literature review was registered on Prospero as 2018 CRD42018102278. Results: Seventy‐four articles with evaluation of sexual function were included. Of the 25 PROMs assessing sexual function, the Female Sexual Function Index (FSFI) was the most frequently used (34/74 [45.9%] items), followed by the Female Sexual Distress Scale (9/74 [12.2%] items) and the Sexual Activity Questionnaire (SAQ) (8/74 [10.8%] items). The most commonly used measurement properties were "hypothesis testing" and "responsiveness". The PROMs with a high level of evidence for these two measurement properties were the FSFI, the SAQ, the Short Sexual Functioning Scale, the Sexual Satisfaction Scale for Women, Sexual Quality of Life‐Female, the Brief Profile of Female Sexual Function, and the Sexual Health Outcomes in Women Questionnaire. The FSFI questionnaire appeared to be more relevant for evaluating medical treatment, and the SAQ for evaluating surgical treatment. Only one instrument was specific to endometriosis (the Subjective Impact of Dyspareunia Inventory [SIDI]). Conclusions: In this systematic literature review of sexual function assessment questionnaires in endometriosis, the FSFI and the SAQ questionnaires emerged as having the best measurement properties according to the COSMIN criteria. The FSFI questionnaire appears to be suited for evaluating medical treatment, and the SAQ for surgical treatment. The SIDI is the only specific questionnaire, but its responsiveness remains to be defined. [ABSTRACT FROM AUTHOR]

Sexual shame and dysfunctional sexual beliefs are very important in sexual relationships. Therefore, the present research was conducted with the aim of predicting sexual performance based on sexual shame and ineffective sexual beliefs. This study was of a descriptivecorrelational type. Using the availability sampling, 400 women working in the administrative departments of the universities of Tabriz were selected. By means of the sexual function questionnaire (female sexual function inventory-2004), Sexual Shame Inventory-2021 and Sexual Dysfunctional Beliefs Questionnaire-2003, the data was collected and analyzed simultaneously using Pearson correlation and multiple regression. There was a negative and significant relationship between the general index of women's sexual performance and all components of sexual shame and ineffective sexual beliefs (p<0.05). Among the examined components, all sexual shame components and some components of sexual dysfunctional beliefs (body image, emotional priority and maternal priority) had the ability to predict sexual performance and explained 63% of its variance. The results showed that sexual shame and having ineffective sexual beliefs lead to the weakening of sexual performance. Considering dysfunctional sexual beliefs and signs of sexual shame to diagnose and treat sexual problems requires effective conceptualization. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What is the relationship between sexual function, health-related quality of life (HRQoL), and laparoscopic surgery in individuals living with endometriosis? SUMMARY ANSWER A higher number of laparoscopic surgeries is significantly associated with poorer HRQoL and greater levels of sexual dysfunction in individuals with endometriosis. WHAT IS KNOWN ALREADY Prior research indicates that endometriosis is associated with lowered HRQoL and sexual function and that these outcomes are influenced by endometriosis-related symptom profiles, medical, and surgical management. A limited number of studies have examined changes in sexual function in individuals with endometriosis following laparoscopic surgery or following repeated surgeries. STUDY DESIGN, SIZE, DURATION A cross-sectional community-based online survey was used to examine the relationships between sexual function, HRQoL, and laparoscopic surgery (n   =   210). PARTICIPANTS/MATERIALS, SETTING, METHODS Individuals with a self-reported diagnosis of endometriosis were recruited via online advertising through social media and gynaecology clinics. Endometriosis-specific data (e.g. diagnostic delay, symptom experience) was collected in addition to engagement with laparoscopic surgery, level of HRQoL (EuroQol-5 Dimension: EQ-5D-5L), and sexual function (Female Sexual Function Index: FSFI). Bivariate correlational analyses and hierarchical multiple regression were used to determine the associations between the variables of interest. MAIN RESULTS AND THE ROLE OF CHANCE Individuals with endometriosis have substantially poorer HRQoL in comparison to Australian normative samples, with greater levels of endometriosis-related symptom burden, distress, and pain significantly associated with lower levels of HRQoL. The mean FSFI score was suggestive of clinically significant female sexual dysfunction, with the lowest level of function noted in the domain of sexual pain and the highest level of function noted in the sexual satisfaction domain. A greater number of laparoscopic surgeries was significantly associated with poorer overall HRQoL and greater levels of sexual dysfunction. LIMITATIONS, REASONS FOR CAUTION The cross-sectional nature of the data precludes direct findings of causality and further longitudinal research is recommended. The information pertaining to engagement in laparoscopic surgery was self-report in nature and was not medically verified. WIDER IMPLICATIONS OF THE FINDINGS The study's findings highlight the pervasive impact of endometriosis on all domains of living, emphasizing the need to extend treatment planning beyond that of physical pain management alone. Early referral for assessment and management of sexual wellbeing is recommended prior to, and post-surgical intervention, with a focus on maintaining post-surgical changes, potentially reducing the need for multiple surgeries. STUDY FUNDING, COMPETING INTEREST(S) The study was not associated with research funding. Author CN reports grant funding from the Australian Government and Medical Research Future Fund (MRFF) and was a previous employee of CSL Vifor (formerly Vifor Pharma Pty Ltd). TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]