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Introduction: This study evaluates the efficacy and safety of non-ablative diode laser therapy for genitourinary syndrome of menopause (GSM) in post-menopausal women unable to use hormonal therapies. Methods: A pilot prospective study was conducted from September 2023 to April 2024, involving 22 post-menopausal women aged 45–73 years. Participants underwent three sessions of diode laser treatment with the Leonardo® dual-wavelength Diode laser. Assessments were made at baseline, 3 months, and 6 months post-treatment. Main outcome measures included Visual Analog Scale (VAS) scores for GSM symptoms, Vaginal Health Index Score (VHIS), and sexual function evaluated using the Female Sexual Function Index (FSFI-6), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and Sexual Quality of Life-Female (SQOL-F) questionnaire. Results: Significant improvements were observed in VHIS, increasing from 12 to 19.27 at 6 months (p < 0.001). GSM symptoms improved significantly: vaginal dryness scores decreased from 7.72 ± 2.37 to 3.72 ± 2.53, burning sensation scores dropped from 6.00 ± 3.22 to 1.90 ± 1.81, and dyspareunia scores reduced from 8.09 ± 2.11 to 3.90 ± 2.58 (all p < 0.016). Sexual function improved, indicated by FSFI-6 scores increasing from 12.27 ± 7.29 to 19.30 ± 6.24 (p < 0.016) and SQOL-F scores rising from 63.18 ± 22.93 to 71.45 ± 23.31. No adverse events were reported. Conclusion: Non-ablative diode laser therapy is effective and safe for managing GSM symptoms in post-menopausal women, offering significant symptom relief and enhancing sexual health without serious side effects. Further research with a larger cohort and extended follow-up is needed to confirm these findings. Trial Registration: Clinical Trials ID NCT06503003. [ABSTRACT FROM AUTHOR]

Purpose of Review: Despite the growing attention toward minority stress, there remains a scarcity of studies on its associations with sexual wellbeing. This scoping review aimed to examine the empirical literature from the last five years concerning how minority stress may relate to sexual wellbeing among adults. Recent Findings: Results from the 13 peer-reviewed articles were inconsistent. Internalized negativity (e.g., homophobia) showed varying associations with sexual satisfaction and function. Concealing one's sexual identity was linked to lower sexual satisfaction and sexual function. Fear of being rejected was associated with worse sexual function. Prejudice-related events were negatively associated with sexual satisfaction and function, and positively with sexual distress. Personal discomfort with one's non-monogamous engagement did not correlate with sexual satisfaction. Summary: Findings suggest that greater minority stress tends to be related to lower sexual wellbeing, albeit inconsistently. Further research is needed to better understand the mechanisms involved in these associations. [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]

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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 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]

Purpose: Sexuality, a substantial factor in quality of life, may be altered after breast cancer (BC) treatments as they intimately afflict femininity. This study aimed to assess the prevalence of sexual dysfunction in women with a history of BC and to compare it with women without a BC history. Methods: The French general epidemiological cohort CONSTANCES includes more than 200,000 adults. All inclusion questionnaires from CONSTANCES non-virgin adult female participants were analyzed. Women reporting a history of BC were compared to controls in univariate analysis. Multivariate analysis was performed to highlight any demographic risk factor for sexual dysfunction. Results: Among the 2,680 participants who had a history of BC, 34% did not engage in sexual intercourse (SI) in the month preceding the completion of the questionnaire (n = 911), 34% had pain during SI (n = 901) and 30% were not satisfied with their sex life (n = 803). Sexual dysfunction was significantly more frequent in women who had a history of BC: they had less sexual interest (OR 1.79 [1.65;1.94], p < 0.001), experienced more pain during SI (OR 1.10 [1.02;1.19], p < 0.001) and were more dissatisfied with their sex life (OR 1.58 [1.47;1.71], p < 0.001). This stayed true after adjustment on multiple demographic factors such as age, menopausal status, body mass index and depression. Conclusions: Overall, in this real-life study in a large national cohort, history of BC appeared to be a risk factor for sexual disorders. Implications for cancer survivors: Efforts to detect sexual disorders in BC survivors and offer quality support must be pursued. [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]

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]

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]

The purpose of the study was to compare the protective effects of robotic rectal cancer surgery (RRCS) and laparoscopic rectal cancer surgery (LRCS) on urinary and sexual function of patients. We conducted a systematic search in the PubMed, Web of Science, Cochrane Library, and Embase for studies comparing the impact of RRCS and LRCS on urinary function and sexual function. The International Prostate Symptom Score (IPSS), the five-item version of the International Index of Erectile Function (IIEF-5) and the Female Sexual Function Index(FSFI) were used to evaluate the urinary function and sexual function of patients. A total of 13 studies comprising 1964 patients were included in this meta-analysis, including 3 randomized controlled trials, 5 retrospective cohort studies, 3 prospective cohort studies, and 2 propensity score-matched studies. Nine hundred and fifty-nine patients underwent RRCS and 1005 patients underwent LRCS. Statistical analysis of the IPSS scores indicated urinary function was significantly better in the RRCS group than in the LRCS group at 3, 6 and 12 months postoperatively [mean difference (MD), − 1.06, 95% CI − 1.85 to − 0.28; and MD, − 0.96, 95% CI − 1.60 to − 0.32; and MD, − 1.09, 95% CI − 1.72 to − 0.46]. Statistical analysis of the IIEF-5 scores indicated male sexual function was significantly better in the RRCS group than in the LRCS group at 3, 6 and 12 months postoperatively (MD, 1.76, 95% CI 0.80 to 2.72; and MD, 1.83, 95% CI 0.34 to 3.33; and MD, 1.05, 95% CI 0.09 to 2.01). Statistical analysis of the FSFI scores indicated female sexual function was significantly better in the RRCS group than in the LRCS group at 6 and 12 months postoperatively (MD, 2.86; 95% CI 1.38 to 4.35; and MD, 4.19; 95% CI 1.85 to 6.54). RRCS is more favorable than LRCS in preserving the urinary and sexual function of patients with rectal cancer. [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 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]

Purpose of Review: Many transgender and gender non-conforming (TGNC) people seek gender-affirming hormone therapy (GAHT). While GAHT is generally safe and increases well-being, it is essential to accurately understand potential unintended effects and risk factors to better inform and manage treatment. This narrative review covers recent literature documenting changes in sexual function following the initiation of GAHT and explores inflammation as a potential mediator of these changes. Recent Findings: Generally, the initiation of GAHT is correlated with increased sexual desire in transgender men and decreased sexual desire in transgender women, with time-limited effects that return to levels approaching baseline after about a year; there are also changes in inflammation markers that parallel this timeline. Findings on other aspects of sexual function (e.g., orgasm, pain, and sexual quality of life) are more limited. As there is evidence from cisgender populations that inflammation acts as a mechanism by which hormones influence sexual function, we propose applying this model to TGNC people taking GAHT. Summary: Sexual function may change in TGNC patients receiving GAHT, and those changes may be influenced by inflammation. However, these changes often return to baseline as TGNC patients' bodies adjust to a new hormonal equilibrium. [ABSTRACT FROM AUTHOR]

Purpose of Review: Recognizing the link between infertility and sexual health is crucial to providing comprehensive fertility care. The aim of this systematic review was to examine studies investigating the prevalence of sexual dysfunction, factors linked to sexual well-being, and psychosocial interventions targeting sexuality in individuals undergoing medically assisted reproduction (MAR). Recent Findings: An advanced search was conducted in Embase, Web of Science, CINAHL, PubMed, and PsycINFO to find articles published between January 2018 and September 2023. After review for eligibility criteria, 83 articles were reviewed. No studies specifically explored the experiences of sexual and gender/sex diverse individuals. In women, rates of sexual function problems varied from 6.9 to 77.3%, whereas it ranged from 6.7 to 53.6% in men. Most studies revealed significantly lower sexual well-being in individuals with infertility compared to those without. Studies identified that women and men achieving pregnancy through MAR reported lower overall sexual function during pregnancy, compared to women and men who conceived without MAR. Studies identified a range of medical, individual, and relationship factors linked to sexual well-being in the context of MAR and suggested that psychological interventions can enhance the sexual well-being of women with infertility. Summary: This systematic review highlights the clear link between infertility, MAR, and lower sexual well-being in both men and women. Future research should prioritize the use of longitudinal designs to allow for a more in-depth exploration of the dynamic changes in sexual experiences over time. Future research should also consider the distinct challenges of sexual and gender/sex diverse individuals and their experiences of sexual well-being during MAR. Finally, there is a potential gap in research focusing on couple-based interventions. Collaborative efforts between reproductive medicine specialists and mental health professionals could ensure a comprehensive approach to addressing the medical and psychosocial aspects of infertility-related sexual issues. [ABSTRACT FROM AUTHOR]

Purpose of Review: Critically assess and evaluate existing measures of sexual function developed for and validated in gender minority individuals (e.g., transgender, non-binary, Two-Spirit, intersex individuals). Provide recommendations for the development of gender minority inclusive measures of sexual function. Recent Findings: The present review describes the measurement development processes and psychometric properties of sexual function assessment tools that have been developed for and validated in gender minority individuals. Two measures of sexual function were recently developed with the intention of being used specifically in gender diverse groups. The Transmasculine Sexual Function Index (TM-SFI) for sexually active transmasculine individuals with cervixes was adapted from the six-item Female Sexual Function Index (FSFI). The Operated Male-to-Female Sexual Function Index (oMtFSFI) is for individuals who have received gender-affirming surgery (GAS), specifically penile skin inversion vaginoplasty. Although the TM-SFI is validated for use in English, the oMtFSFI is currently validated for use only in Italian. Psychometric properties of both measures are discussed, and recommendations for equity-informed measurement applicable to gender minority individuals are provided. Summary: We present a critical review focused on the psychometric properties of two measures of sexual function for gender minority adults. Existing gaps with current measurement tools for this population are discussed, and recommendations are made using best practices in equity-informed measure development relevant to this population. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to determine pelvic pain and sexual dysfunction in primiparous pregnant women with varying levels of fear of childbirth (FOC). Methods: This is a descriptive correlational study. This study was conducted with 400 pregnant women at 24–40 weeks of gestation who applied to the obstetrics polyclinic of a hospital between January 2022 and March 2022. Data were collected through a personal information form, the Wijma Delivery Expectancy Questionnaire (W-DEQ-A), the Pelvic Pain Impact Questionnaire (PPIQ), and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) Female Form. Results: Of the 400 pregnant women, 232 (58%) had high/severe FOC. High/severe FOC was a risk factor that negatively affected pelvic pain and sexual function (frequency of sexual intercourse, communication, sexual satisfaction, avoidance, touching, vaginismus, and anorgasmia) in pregnant women (p < 0.000). In addition, pregnant women with high/severe FOC avoided vaginal examination (p = 0.016), had higher fear of vaginal examination (p = 0.004), experienced more pain or burning during sexual intercourse (p = 0.017), and had more fear of pain during sexual intercourse (p = 0.003). Conclusions: High/severe FOC during pregnancy is an important risk factor that negatively affects pelvic pain and sexual function. Policy Implications: Identifying pregnant women with high/severe FOC and support programs such as antenatal education programs or cognitive coping strategies to cope with FOC may be useful in preventing pelvic pain and sexual functions that may be negatively affected. [ABSTRACT FROM AUTHOR]

Purpose of Review: Benign prostatic hyperplasia affects the quality of life of a significant number of men, especially as they age. There are continuous innovations in the surgical management of benign prostatic hyperplasia, but many of these innovations are studied in the core population of men 50–70 years of age. This review focuses on the outliers of men aged 18–50 and 70 and older. Recent Findings: Older populations have more comorbidities, higher rates of antithrombotic medications, and advanced symptoms. Properly selected older men can safely have significant objective and subjective improvement in their symptoms. The literature was scarce when evaluating younger men; however, ejaculatory preserving techniques are promising providing improvement in symptoms and preserving ejaculation. Summary: This review demonstrates that in properly selected elderly patients, improvements in quality of life while also providing safe surgical interventions can be achieved. Ejaculatory preservation techniques demonstrate promising results, but further studies are required to elucidate true outcomes. [ABSTRACT FROM AUTHOR]

The quality of sexual relationships is one of the essential dimensions of quality of life. Quality of life tools and sexual satisfaction scales are usually quite distinct and do not allow for a comparison between the two genders. The quality of sexual function (QSF) scale measures the quality of sexual relationships and allows for the comparison of women with men. This study aimed to evaluate the reliability and validity of the Persian adaptation of the Quality of Sexual Function Scale. A total of 333 participants were recruited from the clinics of Rasoul Akram Hospital, Tehran, Iran. The scale was translated and adapted by the World Health Organization's (WHO) recommended method. We found a new construct by exploratory factor analysis. The Cronbach's alpha was 0.82 and the McDonald's omega was 0.89. The size of the correlation coefficient between QSF score and age, BMI, and the number of years of married life was trivial. The exploratory factor analysis revealed that the Persian version of QSF consisted of seven dimensions: physical well-being, sexual excitement, mental well-being, expression of sexual wish, desire, satisfaction, being unhappy with sexual life, and sexual dreams. The results of this study revealed that the Persian version of the QSF had appropriate validity and reliability for future studies. The new factorial structure can help to better evaluate the sexual function of patients. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) is one of the most common chronic diseases whose complications harm sexual functioning. Given the importance of sexual functioning and the effects of CAD on it, it is important to identify the factors that can affect sexual functioning. This study aimed to determine the predictive role of health literacy in the sexual functioning of women with CAD. This cross-sectional study was conducted in 2021 on 385 women with CAD who visited comprehensive health centers and doctors' offices in Bushehr Province (Iran) and were selected via convenience sampling. The data were collected using a demographic information form, The Adults Functional Health Literacy questionnaire, and the Female Sexual Function Index. The data were then analyzed using descriptive statistics and logistic regression at the significance level of < 0.05. The mean age of the participants was 52.19 ± 12.15. The mean health literacy score was 72.25 + 24.18. The mean sexual function score was 17.75 + 8.80. Thirty-five percent of the participants had severe or moderate sexual dysfunction. The results showed that high health literacy reduces the risk of overall sexual dysfunction (p = 0.006). The results showed that high health literacy reduces the risk of overall sexual dysfunction and most of its domains. Healthcare and health education specialists should improve the health literacy of women with CAD by using simple and understandable training. It is necessary to conduct prospective studies to determine the causal relationship between the studied variables and confirm the results of the present study. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is an extremely unpleasant and unbearable experience that can have a profound impact on a person’s life. Compared to other types of cancer, breast cancer has a more severe psychological impact on women. Purpose: This study aimed to investigate the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer. Method: A sample of 30 women with breast cancer were randomly divided into intervention and control groups. The research was conducted in the oncology division of Imam Reza Hospital in Kermanshah by the clinical trial method with a two-group pretest–posttest design and a 2 month follow-up. Participants in the intervention group received Mindfulness-integrated cognitive behavior therapy for eight sessions. The intervention was carried out individually in weekly 60 min sessions. While the control group received self-help treatment (through an educational book). A demographic questionnaire, Demoralization Scale (DS-II), Body Image Scale (BIS), and Female Sexual Function Index (FSFI) were used to collect data. For data analysis, means and standard deviations were calculated and repeated measures and the Bonferroni test was conducted using SPSS 26. Results: The results showed the effectiveness of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function (p < 0.05). Concerning demoralization in the intervention group, the pre-test mean was 16.73 ± 3.33, and it reduced to 11.93 ± 1.49 in the post-test. The body image mean score showed a decreasing trend in the intervention group, from 12.47 ± 1.88 in the pre-test to 8.80 ± 3.21 in the post-test. The mean score for sexual function showed an increasing trend, increasing from 18.06 ± 2.29 in the pre-test to 23.07 ± 0.91 in the post-test. There was no significant difference in the mean score of the post-test compared to the pre-test and follow-up in the control group (p < 0.05). Conclusion: MICBT can be used in conjunction with pharmaceuticals and medical treatments to improve the psychological symptoms of women with breast cancer, according to this study’s results. Trial registration (IRCT20160103025817N6). 2022-04-06. [ABSTRACT FROM AUTHOR]

Purposeof Review: Given that the diagnosis and management of overactive bladder (OAB) is directed by symptomatology, the patient perspective is critical to understanding the disease and efficacy of available treatments. We present a narrative review of literature published in the last 5 years surrounding the patient perspective of OAB. Recent Findings: OAB has a negative effect on health-related quality of life (HRQoL). Management of OAB generates significant cost to the patient, including physician visits, incontinence pads, treatment of urinary tract infections, and management of skin infections and irritation. Patients with OAB suffer in terms of work productivity, food insecurity, and financial strain, and these effects are more profound in patients of lower socioeconomic status and education level. Recent literature investigating the effect of β3-adrenergic agonists on patient quality of life demonstrated similar improvements when compared with anticholinergics and potentially greater tolerability in terms of adverse effects. In terms of third-line therapies, sacral neuromodulation (SNM) has been shown to have significant improvement in HRQoL and urinary symptoms while avoiding the need for frequent office visits. Summary: OAB can have a detrimental effect on HRQoL, sexual function, work productivity, and can generate significant cost to the patient. Recent literature demonstrates that existing treatments show promise in terms of improving HRQoL. Patients prefer oral medications over injectable or more invasive therapies; however, a majority of patients who fail medications are willing to trial third-line therapies. Continued investigation of the patient perspective on OAB will be paramount to continue improvement in patient care. [ABSTRACT FROM AUTHOR]

Introduction: Help-seeking regarding sexual health issues is low among women despite its high prevalence. The present study aims to investigate the effect of a mobile app-based psychosexual intervention on enhancing help-seeking behavior of newly married women in Iran, Rasht, regarding their sexual health issues. Methods: This study was a parallel randomized controlled trial, performed during December 25, 2021, to January 12, 2022, on 140 newly married women in Iran, Rasht. Data collection tools included a demographic data questionnaire, General Help-Seeking Questionnaire (GHSQ), Actual Help-Seeking Questionnaire (AHSQ), and the female sexual function index-short form (FSFI-6). The intervention group received psychosexual intervention using a mobile app, the HISSS App, while the control group received an unrelated intervention regarding menstruation hygiene using the Easy Period App. The intervention lasted 6 weeks, and the outcomes were assessed at baseline, immediately after, and 8 weeks after the intervention. Results: A total of 119 participants successfully completed the study. The mean differences between groups for GHSQ and formal AHSQ immediately after the intervention were significant (10.49 [95% CI (8.33 to 12.65)], P <.001; (.57 [95% CI (.23 to.69)], P <.001). They remained significant after 8 weeks as well (11 [95% CI (8.02 to 13.99)], P <.001); (.69 [95% CI (.23 to 1.15)], P =.003) when compared to baseline. However, the between groups mean that differences of informal AHSQ and FSFI-6 were only significant immediately after the intervention (.52, [95% CI (.14,.90)], P =.007); (2.93 [95% CI (2.04, 3.82)], P <.001) and not after 8 weeks. Conclusions: Based on the results of the present study, a mobile app-based psychosexual intervention can enhance help-seeking behavior regarding sexual health issues among women in a short time. Policy Implications: It is recommended that public health policies prioritize community-based interventions to boost the accessibility and effectiveness of both informal and formal help-seeking sources. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Most of the literature on pelvic organ prolapse (POP) has been generated from postmenopausal patients in high-income countries. In the Democratic Republic of the Congo (DRC), a significant proportion of patients who present for surgical management of POP are premenopausal. Little is known about the impact of POP on pelvic floor symptoms in this population. The objective was to describe pelvic floor symptoms and sexual function among premenopausal patients presenting for POP surgery in DRC. Methods: We performed a prospective cohort study of symptomatic premenopausal patients undergoing fertility-sparing POP surgery at a large referral hospital in the DRC. Pelvic floor symptoms were evaluated with the Pelvic Floor Distress Inventory Questionnaire and sexual function with the Pelvic organ prolapse/urinary Incontinence Sexual Questionnaire. Data are presented as means with standard deviations or counts with percentages. Results: A total of 107 patients were recruited between April 2019 and December 2021. All had either stage III (95.3%) or stage IV (4.7%) prolapse. Ages were 34.2 ± 6.7 years; 78.5% were married. A majority of patients experienced low abdominal pain (82.2%), heaviness or dullness (95.3%), and bulging or protrusion of the prolapse (92.5%). Almost two-thirds of patients reported no longer being sexually active, and 80% stated that they were not sexually active because of POP. Of the 37 sexually active patients (34.6%), nearly all reported significant sexual impairment because of the prolapse, with only 4 reporting no sexual impairment. Conclusions: This study represents one of the largest prospective series of patients with premenopausal POP. Our results highlight the severity of pelvic floor symptoms and the negative effects on sexual function among this patient population with POP. [ABSTRACT FROM AUTHOR]

Obesity is associated with increased risk of a number of physical and psychological problems, including heart disease, depression, and sexual dysfunction. We investigated the relationship between Body Mass Index categories, body image, and sexual function using more detailed assessment of potential weight related sexual problems than previous research. We recruited 251 Chinese participants (124 men) aged 18–57 to fill out an online questionnaire regarding sexual function, general body image, body image related to sexuality, and weight-related physical problems during sexual activity. The created body weight category groups with equal age controlling for its potential confounding effect on the association between obesity and sexual function. Participants' and their partners' height and weight as well as the International Index of Erectile Function-5 (IIEF-5), Checklist for Early Ejaculation Symptoms (CHEES), Female Sexual Function Index (FSFI), Body Image States Scales (BISS), sexual body image questions, and a series of questions regarding weight-related physical problems during sex were used. Obese and overweight men had worse erectile and ejaculatory function than normal weight men whereas in women no association with sexual dysfunction was found. Obese and overweight men and women had worse general and sexual body image than normal weight individuals of their gender. For men, Body Mass Index was associated with erectile and ejaculatory function through sexual body acceptance and sexual body shame. In addition, Body Mass Index was associated with ejaculatory function via body image and physical problems related to exhaustion and fat tissue during the sex. For women, Body Mass Index was associated with female sexual function through body image and sexual body acceptance. Finally, we also found that participants' own Body Mass Index was positively associated with their partners' Body Mass Index. The resulted indicate that obesity and overweight have complex relationships with sexual function that clinicians should be aware of. This study is first to investigate the potential mediation psychological and physical factors on the relationship between obesity and sexual function both for men and women. However, the sample size is limited and the cross-sectional design does not allow causal conclusions. Body Mass Index is associated with individuals' sexual functioning via satisfaction with their own body, body satisfaction specifically related to sexual activity as well as physical problems during sexual activity. [ABSTRACT FROM AUTHOR]

Purpose: Positive sexuality has received little empirical attention in relation to eating disorders. Two tendencies related to sexuality have been identified among women with anorexia nervosa (avoidance) and bulimia nervosa (disinhibition), but it is unclear if they also apply to women with binge eating episodes without compensatory behaviors. This study aimed at (1) exploring the sexual self-concept, functioning, and practices of women with binge eating episodes with or without comorbid restrictive and/or compensatory behaviors, considering past experiences of violence, and (2) verifying the presence of distinct profiles of sexual dispositions among this population. Methods: In total, 253 women reporting recurrent episodes of loss of control related to food intake in the past 5 years, completed a web-based questionnaire. Descriptive and correlational analyses were conducted to outline participants’ sexual self-concept, functioning, and practices and to examine the relationship between these factors. A two-step cluster analysis was also performed to determine whether participants presented distinct profiles of sexual dispositions. Results: Participants were generally characterized by a negative sexual self-concept and poor sexual functioning. While a first subgroup of participants displayed a pattern of sexual difficulties and avoidance, a second subgroup had a positive sexual self-concept, better sexual functioning and a wider range of sexual practices. Subgroups did not differ relative to binge eating. Conclusions: Sexuality offers a platform for positive embodiment, which can lead to the improvement of body image and mind–body connection and may thus constitute an essential clinical target to improve treatment related to binge eating episodes. Level of evidence: Level II: The experimental study is a non-randomized controlled trial. [ABSTRACT FROM AUTHOR]

Purpose of Review: Gender-affirming vaginoplasty is associated with a high degree of patient satisfaction; however, transgender and gender diverse individuals may face significant challenges regarding sexual dysfunction postoperatively. Sexual function is complex and multifaceted, and data regarding postoperative sexual function can help guide patient counseling and decision-making. Recent Findings: While much of the literature on outcomes of gender-affirming vaginoplasty has focused on capacity to achieve orgasm, numerous parameters of sexual function may impact patient satisfaction and quality of life. Patients may experience decrease in sexual desire and arousal following gender-affirming vaginoplasty; however, the impact of dysphoria vs additional psychosocial factors impacting sexuality vs organic sexual dysfunction remains unclear. Correlation of clitoral function with patient satisfaction is complex and not easily determined. Preoperative anorgasmia may predict postoperative anorgasmia; however, preoperative anorgasmia related to gender dysphoria and incongruence may resolve postoperatively. Summary: While progress has been made in the literature surrounding gender-affirming vaginoplasty, existing limitations may make it difficult to appropriately counsel patients regarding surgical outcomes related to sexual health. Heterogeneity in study methodology and quality limits the ability to make specific recommendations regarding differences in technique, and there remains a significant need for high-quality, validated patient-reported outcome measures regarding sexual function post-gender-affirming vaginoplasty. [ABSTRACT FROM AUTHOR]

Purpose of Review: The purpose of this study was to review the recent literature on the relationship between intimate partner violence (IPV) and sexual health in women (including sexual functioning, sexual satisfaction, and relationship satisfaction). Recent Findings: IPV harms women's health, including their sexual health. Of the negative consequences, IPV is associated with worse sexual functioning, sexual satisfaction, and relationship satisfaction. Summary: Recent findings show that IPV is associated with worse sexual functioning (i.e., partner-focused dyadic and general sexual desire, sexual arousal, and orgasmic capacity), low sexual satisfaction, and low relationship satisfaction. Furthermore, only eight studies have been published in the last 10 years. Although very few articles were identified to have assessed the relation between IPV and sexual health aspects in the literature, it can be stated that IPV is related to worse sexual health in women victims. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Little is known about the impact of native tissue repair techniques on heterosexual intercourse. This study was aimed at investigating the effect of anterior colporrhaphy on women's and their partners' sexual function. Methods: Sexually active women with a male partner who were diagnosed with anterior wall prolapse without any incontinence were prospectively recruited from a single academic center. Demographic data were collected and a Pelvic Organ Prolapse Quantification examination was performed. Before and 3 months post-operatively, women completed two validated questionnaires to assess sexual function, the International Consultation on Incontinence Questionnaire Vaginal Symptoms short form (ICIQ-VS SF) 55, and the Female Sexual Function Index (FSFI), and their male partners completed the International Index of Erectile function-5. Pre- and post-operative results were compared using a paired t test. Results: This study was conducted in the gynecology department of a university hospital between May 2022 and June 2023, where 50 heterosexual couples were enrolled and underwent isolated anterior repair. The mean age of women and their partners were 44.3 ± 5.12 and 48.1 ± 5.81 respectively. Overall, female sexual function improved significantly from pre- to 3 months postoperatively with a decrease in ICIQ-VS SF scores from 13.3 ± 3.27 to 1.7 ± 1.1 (p < 0.05) and an increase in FSFI scores from 21.74 ± 9.37 to 29.28 ± 9.97 (p < 0.05). The only domain that did not improve was sexual pain. For their male partners, there was a similar significant improvement in sexual function with an increase in scores from 48.71 ± 8.71 to 60.68 ± 8.63 (p < 0.05). Conclusions: Isolated anterior repair was associated with improved short-term sexual function amongst heterosexual couples. [ABSTRACT FROM AUTHOR]

Purpose of Review: Sexual dysfunction is commonly associated with overweight/obesity, but the underlying physiological and psychosocial mechanisms are not fully understood. This review contextualizes the obesity-sexual (dys)function relationship, describes recent insights from the medical and social science literature, and suggests opportunities for continued research. Recent Findings: Although sexual dysfunction has been historically evaluated as a consequence/outcome of obesity, it is increasingly considered as a harbinger of future metabolic comorbidities, including type 2 diabetes and cardiovascular disease. Body image dissatisfaction is a consistent predictor for lower sexual satisfaction across BMI categories, likely mediated by cognitive distraction during partnered sex. Summary: To fully capture the relationship between obesity and sexual dysfunction, multidisciplinary research approaches are warranted. While clinically significant weight loss tends to improve sexual functioning for women and men, higher body image satisfaction may independently promote sexual function and satisfaction without concomitant weight loss. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Bladder pain syndrome (BPS)/interstitial cystitis can adversely affect physical, mental, and sexual health. The aim of the systematic review is to compare sexual function between patients with BPS and healthy controls and to examine whether or not treatment of BPS improves sexual function. Methods: A literature search was conducted on Embase, Medline, and other databases. Studies comparing sexual function in BPS patients with healthy controls and before/after treatment were included. Where appropriate, data were pooled in a meta-analysis, using a random effects model and the standardised mean difference (SMD) was used for comparison. Results: Out of 384 studies initially identified, 26 studies met the inclusion criteria for the systematic review and 11 for the meta-analysis. Six studies compared sexual function in BPS cases with healthy controls. All studies found that the Female Sexual Function Index (FSFI) was worse in BPS cases than in controls. Pooled data from 5 studies showed that the SMD was −1.02 (CI −1.64, −0.4) in total FSFI scores between the cases and controls, p=0.001. Further analysis showed better sexual function in all FSFI subdomains in healthy controls. Five studies compared sexual function in BPS patients before treatment with after treatment. Pooled data from 3 studies showed an overall improvement in total FSFI score after intravesical treatment: SMD=0.69 (CI 0.23, 1.14), p=0.003. Further analysis showed improvement in all subdomains. Conclusion: Our review suggests that sexual function might be worse in BPS patients than in the general population, but it seems to improve with intravesical BPS treatment. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The worldwide prevalence of sexual dysfunction in women is high; therefore, an adequate assessment of this condition is necessary, with instruments validated for the Brazilian population. The aim was to translate and adapt the International Consultation on Incontinence Questionnaire Female Sexual Matters Associated with Lower Urinary Tract Symptoms into Brazilian Portuguese (ICIQ-FLUTSsex-Br) and analyze its measurement properties. Methods: We recruited Brazilian women, literate, over 18 years old, who had had sexual intercourse in the last 4 weeks and had urinary loss. The translation and cross-cultural adaptation were performed following five stages: translation, synthesis, back translation, expert committee review, and pre-test. Measurement properties were analyzed using SPSS software, as follows: test–retest reliability using the intraclass correlation coefficient (ICC); construct validity using Pearson's correlation coefficient, by correlating the ICIQ-FLUTSsex-Br with the Female Sexual Function Index (FSFI) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Results: A total of 328 women participated in the study. The reproducibility was 0.88, the standard error of measurement was 0.29, and the minimal detectable change was 0.80 (95% CI). Moderate correlations were found between the total scores of the ICIQ-FLUTSsex and PISQ-12 questionnaires (0.54, p<0.01), confirming the hypotheses outlined. Weak correlations were also found for comparisons between the FSFI and ICIQ-FLUTSsex total scores (−0.56, p<0.01) and the PISQ-12 question about fear of incontinence hindering sexual intercourse (0.26, p<0.01). Conclusion: The Portuguese-language version of the ICIQ-FLUTSsex-Br showed validity and reproducibility, making it a tool to be used in research and clinical practice by health professionals in Brazil. [ABSTRACT FROM AUTHOR]

The notions that manhood is hard to attain, easy to lose, and needs to be proven via public action constitute precarious manhood beliefs (PMB). PMB is a new concept and it remains unclear whether and how PMB relate to erectile dysfunction (ED) in cisgender men. The ability to achieve an erection remains considered as a cornerstone of masculinity and sexual performance can be conceived as a proof of one's masculinity. In this context, ED can be received as sexual failure and a threat to a man's masculinity and sense of adequacy. For these reasons, the hypothesis that PMB are associated with ED warranted empirical testing. In an anonymous online survey focusing on men's mental health conducted in German-speaking countries of Europe, 507 cisgender men (Mage = 44.2, SDage = 15.2) completed measures on PMB, sexual function, self-stigma, social desirability, and conformity to traditional masculinity ideology (TMI). Multilinear regression analysis with stepwise introduction of relevant covariates evaluated potential associations between PMB and ED. Of a 507 cisgendered male sample, 63.1% reported an increased risk for ED based on previously established cutoff points. Elevated levels of PMB endorsement among the men predicted reduced sexual and erectile function in all models, even when accounting for relevant control variables such as age, education, self-stigma, social desirability, or conformity to TMI. Group comparisons revealed that the men suffering from ED showed higher levels of PMB endorsement but not self-stigma nor TMI relative to men without ED. PMB are significantly associated with ED. While determining causality will require further study, our results may support the hypothesis that higher levels of PMB endorsement may lead to increased tension to perform sexually, resulting in increased psychological pressure and a higher risk to develop ED. [ABSTRACT FROM AUTHOR]

Introduction: Being one of the most practiced procedures in plastic surgery, it is important to foster a better understanding of the effect of anatomical changes in the pubic area after abdominoplasty on sexuality in women. Since to date no study has been performed with this purpose, our aim is to evaluate the impact of the abdominoplasty on sexual pleasure and to perform an objective evaluation of changes in clitoral position and prepubic fat area after this procedure. Materials and Methods: A prospective study has been performed in 50 women who expressed a desire to undergo abdominoplasty from January 2021 to December 2021. The primary endpoint was Sexual pleasure assessed by the "Sexuality Assessment Scale" before and 6 months after abdominoplasty in all patients. Furthermore, we evaluated the physical changes of the clitoris (clito-pubic distance, CP distance) and the prepubic fat area on magnetic resonance imaging before and 3 months after abdominoplasty. Results: Patients mean age was of 42 ± 9 years, and mean body mass index of 26 ± 2 kg/m2. A significant difference (P < 0.0001) between sexual satisfaction before and 6 months after abdominoplasty (mean difference +7.4 ± 6.452) was found. Though there was no significant difference between the clito-pubic distance before and after abdominoplasty (mean difference −3.200 ± 2.499 mm; p= 0.0832), a significant difference was found in the size of the prepubic fat area before compared to after abdominoplasty (mean difference −1.714 ± 1.010 cm2; p = 0.0426). However, no significant relationship between these anatomical changes and sexual satisfaction was found. Conclusion: Our results show that abdominoplasty is associated with an increase in sexual satisfaction. The changes in the post-operative position of the clitoris were not statistically significant, contrarily to the size of the prepubic fat area, which was significantly modified and could partially explain the improved sexual pleasure. Authors were unable to statistically demonstrate a correlation between those anatomical modifications and sexual pleasure. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Purpose of Review: Erectile dysfunction (ED) is an increasingly common concern that has been a topic of interest to men (and their partners) since time immemorial. In the year 2023, we mark a quarter century since selective phosphodiesterase type 5 inhibitors (PDE5I) came to market as the first United States Food and Drug Administration (USFDA) approved oral pharmacotherapy for ED. Recent Findings: The past 25 years have seen a major shift in public discourse on sexuality and sexual dysfunction, to a large extent prompted by the safety and ease of availability of these drugs. The positive impact of the drug on men and their partners is undeniable. The advent of PDE5I has not been without controversy, and in some regards, the sheer simplicity of the drugs' use may have compromised consideration of more deep-seated psychological and interpersonal dimensions of sexuality. Summary: The clear link between ED and cardiovascular disease and even mortality also underscores how simply taking a pill to address the immediate goal of a rigid penis may lead to the person with ED overlooking potentially serious medical problems, of which ED may be a harbinger. In this manuscript, we outline our perspectives on use (and misuse) of PDE5I as a certified sex therapist and a board-certified urologist with interest in sexual medicine. We highlight areas of agreement and disagreement and hopefully provide readers of all disciplines with perspectives on how to optimize sexual wellness for all of our patients, with or without PDE5I. [ABSTRACT FROM AUTHOR]

Introduction: Patients with urinary incontinence may fear sexual activity due to the unpredictability of urine leakage during intercourse. Given the effective role of cognitive–behavioral therapy in correcting negative thoughts and attitudes, this study was aimed to investigate the effect of cognitive–behavioral therapy on sexual self-esteem and sexual function of reproductive-aged women suffering from urinary incontinence. Methods: This study was a randomized controlled clinical trial conducted on 84 reproductive-aged women (18 to 45 years old) with urinary incontinence who referred to Health Centers of Dezful, Iran. After random allocation, the participants were divided into two groups of intervention and control (n = 42). The intervention group attended eight 45-min sessions of cognitive–behavioral therapy, while the control group received only routine interventions. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the Scale of Self-Esteem Index for Women-Short-form (SSEL-W-SF), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12) were completed before, immediately after, and 4 weeks after the end of the intervention by patients in both groups. Results: The overall scores of sexual self-esteem and sexual function immediately and 4 weeks after the end of the intervention showed a statistically significant difference in the intervention group compared to the control group (p < 0.001). Also, the results showed that in women with urinary incontinence, an increase in the sexual self-esteem score is associated with an increase in the sexual function score (r = 0.9), p < 0.001). Conclusion: Cognitive–behavioral therapy was found to increase sexual self-esteem and improve sexual function in reproductive-aged women suffering from urinary incontinence. [ABSTRACT FROM AUTHOR]

Background: Migraine is believed to affect over 20% of people at some point in their lives. The presence of sexual dysfunction in migraine sufferers can cause lack of self-confidence and divorces. The aim of this work is to study sexual dysfunction in migraine headache patients. Methods: The study was carried out at Tanta University Hospital. The study included married patients who visited our hospital clinic and have had episodic or chronic migraine headaches and another group of age and sex matched healthy subjects will be recurited as a control group. Our interview includes questions for disease duration, severity and frequency of headache attacks and attack duration. questionnaire. the Arabic Version of the Migraine Disability Assessment Scale and Beck depression inventory. Sexual function will be evaluated by an Arabic version of Arizona sexual experience scale. Results: The ASEX score showed high significant changes between migraine patients and healthy subjects. These changes were reconfirmed when comparing male patients to healthy subjects or female patients to healthy subjects.Despite there was no significant difference regarding total ASEX score between bot male and female patients with migraine there was significant differences in the items of derive, erection/lubrication and satisfaction between them. In patients with migraine the total ASEX score was correlated with the MIDAS, Beck depression inventory, Beck anxiety inventory; but not with the age of patients or headache duration. Conclusions: Sexual dysfunction is a common finding in migrine patients which is poorly evaluted in the clinical sitting. [ABSTRACT FROM AUTHOR]

Purpose: The impact of cancer diagnosis and treatment on sexual quality of life (SQoL) is a significant and often neglected issue in the treatment and survivorship period of young gynaecological cancer survivors (YGCS). This study sought to explore women's lived experiences to understand how to protect and improve SQoL. Methods: A qualitative study with women aged 18–45 and pre- or perimenopausal at diagnosis (n = 15). A thematic analysis was performed in NVivo. Participants also completed a pre-interview questionnaire and The Female Sexual Distress Scale-Revised (FSDS-R). Results: YGCS experienced high psychosexual distress. Notably, seven themes were identified: adjustment, confidence, fear, loss, shame, trauma, and communication. Gynaecological cancer (GC) treatment interfered with everyday life and had a long-term impact on mental, physical, and emotional health, with many reporting an altered sense of self, body image and sexual identity. Single women felt vulnerable in new relationships, while partnered women reported low sexual desire and guilt about sexual difficulties. Open communication, emotional intimacy, and an acceptance of the 'new normal' buffered the trauma of cancer and were vital to relationship satisfaction. Lastly, absent, or blunt patient-clinician communication contributed to psychosexual distress. Conclusion: GC interferes with sexual function, partner relationships, psychosexual wellbeing, and quality of life. A better understanding of the lived experiences of YGCS can help healthcare providers to adopt a holistic, patient-centric, and multidisciplinary approach to SQoL. YGCS want psychosexual communication and support, across all stages of treatment and care. Healthcare providers should initiate and normalise conversations on the impact of treatment on SQoL. [ABSTRACT FROM AUTHOR]

Systemic Lupus erythematosus (SLE) is a multisystem autoimmune disease. This disease triggers sexual dysfunction due to physiological, cognitive and mental effects. Since sexual function is often ignored in these patients, this study aimed to investigate the effect of sexual counseling based on EX‑PLISSIT model on improving the sexual function of married women with SLE. This clinical trial was conducted on 101 married women suffering from SLE (18–49 years) residing in Tehran. Randomization was performed by random block allocation with six blocks in a rheumatology clinic. A demographic questionnaire, the Depression, Anxiety, Stress Scales-21 Items (DASS-21), and the female sexual function index were used to collect the data. The intervention group received counselling sessions every week while the control group (n = 55) received routine care for the disease. Eight and twelve weeks after completion of counselling sessions, outcomes compared between the intervention and control groups, using independent ttest, paired t-test, repeated measures and Chi-squared test. The scores of sexual function in both groups did not differ significantly before the intervention (p > 0.05). At the first follow-up session, the score of all sexual function domains except sexual pain increased significantly in the intervention group while a significant reduction was observed in all domains of sexual function in the control group (p < 0.05). In the second follow-up, sexual function significantly increased in the intervention group whereas it significantly decreased in the control group (p < 0.05). According to the findings of this study, counseling based on EX-PLISSIT model positively affected the sexual function of women with SLE. Therefore, this model can be used as a cost-effective and simple counseling method to improve the sexual functions. [ABSTRACT FROM AUTHOR]

Purpose: Chronic graft-versus-host disease (cGVHD) is a common late complication of allogeneic hematopoietic cell transplantation (HCT). This study comprehensively evaluated physical and psychological function among individuals with cGVHD. Additional aims were to investigate relationships between disease severity and psychological and physical function, and to investigate patterns of psychological and physical function by disease site. Method: Adults at least 6 months post allogeneic HCT were enrolled and either had cGVHD (n =59) or served as a reference sample of HCT survivors with no cGVHD history (n = 19). Participants completed self-report measures of depression, anxiety, fatigue, insomnia, pain, cognition, and sexual function and had a comprehensive clinical evaluation of cGVHD using NIH consensus scoring criteria. Participants with cGVHD were stratified by disease severity and site and compared to the reference group with no cGVHD. Results: Participants with mild cGVHD had comparable psychological and physical symptoms to the reference sample, while participants with moderate cGVHD experienced more severe anxiety and problems with sexual function, and participants with severe cGVHD experienced more severe depressive symptoms and pain compared to the reference sample. Participants with cGVHD manifesting in the skin and GI tract had the most severe symptoms, including mood disturbance, fatigue, and pain. Conclusions and Implications for Cancer Survivors: Results suggest that patients with more severe cGVHD and those with cGVHD manifesting in the skin, GI tract, and lungs are at risk for poorer psychological and physical outcomes and may benefit from proactive interventions to optimize function. [ABSTRACT FROM AUTHOR]

Purpose of Review: Currently, there are a lack of systematic and standardized methods to evaluate sensation in individuals who have undergone masculinizing gender affirmation surgery (GAS). An individual's choice to pursue phalloplasty or metoidioplasty is driven by consideration of cosmetic satisfaction, urethral function, phallic rigidity, and penetrative ability. Regardless of the chosen procedure, phallic sensation is desired for satisfactory sexual function, pleasure, and overall well-being. The purpose of this review is to evaluate the current literature on sensory outcomes after masculinizing GAS and to identify gaps in knowledge that may benefit from further research. Recent Findings: There is great variability in the collection and reporting of sensation, orgasm, and sexual function data. Due to design limitations and potential bias, all included studies received "low" or "very low" GRADE of evidence. Tactile and erogenous sensation were the most common types of sensation reported. Although most studies report that their participants are eventually able to achieve erogenous and tactile sensation, it is difficult to draw firm conclusions due to significant variability in methodology and results. Additionally, there is limited available literature poised to compare sexual function outcomes between phalloplasty techniques and donor tissue sites. Percentages of participants able to orgasm via masturbation ranged from 71.8 to 100%, while orgasming with sexual intercourse ranged from 69.5 to 100%. Fewer than half of studies discussed the ability for penetrative sex. Between these studies, the ability to engage in penetrative sex ranged from 39.5 to 75%. Only two studies reported the length of time post-operatively to orgasmic ability; both reported that participants were able to orgasm by 1 year post-op. Summary: Overall, there are a wide variety of surgical techniques for GAS described in the literature. The data on sensation, orgasm, and sexual function remains limited, but the authors of this manuscript feel that this study highlights gaps that future researchers may seek to fill. [ABSTRACT FROM AUTHOR]

The prevailing narrative about sexual declines during the transition to parenthood is largely based on studies assessing the average couple, but there is increasing evidence of variability in the sexual well-being of new parents. We sought to establish distinct subgroups of couples based on sexual function and sexual distress trajectories and examine biopsychosocial risk and protective factors of these trajectories. A prospective cohort of 257 first-time parent couples reported on sexual function and sexual distress from 20-week pregnancy (baseline) to 6 months postpartum across four time-points. Biopsychosocial factors were assessed at baseline and 3 months postpartum. Dyadic latent class growth analysis identified two distinct sexual function classes (high, 85%; discrepant, 15%) and three sexual distress classes (low, 77%; moderate, 12%; discrepant, 11%). We identified biomedical (vaginal delivery, perineal tear, breastfeeding) and psychosocial (fatigue, stress, anxiety, depression, attitudes toward sex during pregnancy, relationship quality, perceived partner support) factors that can be assessed at critical time-points (i.e., 20-week pregnancy and 3 months postpartum) to identify high-risk couples. Current results indicate that the course of change in sexual well-being for new parents is heterogeneous, with most new parents retaining high function and low distress and only a minority showing trajectories in which mothers, but not fathers, experience clinically significant and persistent levels of low sexual function and high sexual distress. These results may facilitate more nuanced approaches to the assessment and intervention of new parents' sexual well-being. [ABSTRACT FROM AUTHOR]

Although there is growing evidence of an association between disordered eating and sexual dysfunction, the mechanism underlying this association is still unclear. In the current study, we sought to examine the mediating role of sexual motivation between disordered eating and sexual dysfunction. We used a multi-path mediation model to examine the mediating role of sexual motivation between disordered eating and sexual functioning among a sample of 341 non-clinical women in a steady relationship. Analysis revealed two significant mediation paths associating disordered eating with sexual functioning: (1) a high level of disordered eating was significantly linked with higher motivation for partner approval via sex and sexuality which, in turn, was associated with lower sexual functioning and (2) a high level of disordered eating was significantly linked with lower enhancement sexual motivation which, in turn, was associated with lower sexual functioning. This study extends the existing knowledge by offering an explanation for the relation between disordered eating and sexual dysfunction via sexual motives. Findings from the current study suggest women with disordered eating utilized sex for self-affirmation, for coping with negative emotions, for partner approval, and to increase intimacy. Also, these women were not likely to engage in sex for enhancement reasons. [ABSTRACT FROM AUTHOR]

To evaluate associations between the domains of the ANCA-associated vasculitis patient-reported outcome (AAV-PRO) instrument and clinical variables. Patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA), or renal-limited vasculitis (RLV) were recruited from a tertiary care center in Mexico City. Demographic, clinical, serological, and treatment-related data were retrieved. Disease activity, damage, patient and physician global assessments (PtGA and PhGA) were evaluated. All patients completed the AAV-PRO questionnaire, male patients also completed the International Index of Erectile Function (IIEF-5) questionnaire. Seventy patients (44 women and 26 men) were included, with a median age of 53.5 years (43–61), and a disease duration of 82 months (34–135). Moderate correlations were identified between the PtGA and the AAV-PRO domains: social and emotional impact, treatment side effects, organ-specific symptoms, and physical function. The PhGA correlated with the PtGA and prednisone doses. Subanalyses of the AAV-PRO domains according to sex, age, and disease duration showed significant differences in the treatment side effects domain, with higher scores in women, in patients < 50 years, and in patients with disease duration < 5 years. The domain of concerns about the future showed a higher score in patients with disease duration < 5 years. A total of 17/24 (70.8%) of men who completed the IIEF-5 questionnaire were classified as having some degree of erectile dysfunction. The domains of AAV-PRO correlated with other outcome measures, while differences were found between some of the domains according to sex, age, and disease duration. [ABSTRACT FROM AUTHOR]

Male reproductive functions, which include testicular steroidogenesis, spermatogenesis, and sexual/erectile functions are key in male fertility, but may be adversely altered by several factors, including hypoxia. This review demonstrates the impact of hypoxia on male reproductive functions. Acute exposure to hypoxia promotes testosterone production via stimulation of autophagy and upregulation of steroidogenic enzymes and voltage-gated L-type calcium channel, nonetheless, chronic exposure to hypoxia impairs steroidogenesis via suppression of the hypothalamic–pituitary–testicular axis. Also, hypoxia distorts spermatogenesis and reduces sperm count, motility, and normal forms via upregulation of VEGF and oxidative stress-sensitive signaling. Furthermore, hypoxia induces sexual and erectile dysfunction via a testosterone-dependent downregulation of NO/cGMP signaling and upregulation of PGE1/TGFβ1-driven penile endothelial dysfunction. Notably, hypoxia programs male sexual function and spermatogenesis/sperm quality via feminization and demasculinization of males and oxidative stress-mediated alteration in sperm DNA methylation. Since oxidative stress plays a central role in hypoxia-induced male reproductive dysfunction, studies exploring the effects of antioxidants and upregulation of transcription of antioxidants on hypoxia-induced male reproductive dysfunction are recommended. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effect of the stoma on sexual function in colorectal cancer patients. Methods: Search strategy was conducted in four databases including PubMed, Embase, the Cochrane Library, and Medline on Nov 20, 2022. After that, the quality of eligible studies was assessed by the Newcastle Ottawa Scale (NOS) and the Agency for Healthcare Research Quality (AHRQ). In order to evaluate the sexual function between the stoma group and the non-stoma group, mean values and standard deviation were pooled for scores in questionnaires, and odds ratio and 95% confidence intervals were pooled for self-designed problems. Results were shown in forest plots; Egger's test and the trim and fill analysis were used for assessing the publication bias. All the data analyses above were performed by STATA 16.0 software. Results: Six cohort studies and three cross-sectional studies were included for this pooling up analysis. As for the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-C38), male patients with stomas had more sexual problems (mean differences = 0.32, 95% confidence intervals = 0.01 to 0.63, I2 = 67.80%, P = 0.05); however, other indicators including sexual functioning, sexual enjoyment, and female sexual problems had little difference between the two groups. As for other questionnaires and problems, stoma did not have an impact on sexual function. Conclusion: The stoma after surgery was not significantly associated with the sexual function of female patients with colorectal cancer and was associated with worse scores on only sexual problems for males. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The purpose of this study is to determine the effects of sexual counseling and pelvic floor relaxation on sexual functions in women receiving vaginismus treatment. Methods: A total of 34 women at the vaginismus treatment stage, including 17 in the experiment group and 17 in the control group, were included in the study with a randomized controlled design. In addition to the routine treatment protocol, women in the experiment group were provided with pelvic relaxation and sexual counseling based on the Information, Motivation, Behavior (IMB) model consisting of four sessions. The control group received the routine treatment protocol. The assessments were made at the 3rd week and 2nd month after coitus. The women filled out an Information Form, the validated Female Sexual Function Index (FSFI), and the Vaginal Penetration Cognition Questionnaire (VPCQ). Results: The mean age of the women was 27.59±5.32, and their mean duration of marriage/relationship was 33.44±12.11 months. After the treatment statistically significant increases were observed in the total FSFI scores and the desire, arousal, and pain dimension scores of the experiment group in comparison with the control group (p<0.05). In the VPCQ total scores, there was a significant reduction in the experiment group in comparison with the control group and after the treatment in comparison with before the treatment (p<0.01). Conclusions: The sexual counseling based on the IMB model and pelvic relaxation interventions provided to the women who were receiving vaginismus treatment affected their sexual function positively. It may be recommended to conduct comparative studies with a broader sample and different models. [ABSTRACT FROM AUTHOR]