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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]

The present study investigated primary care patients and compared self-reported sexual health in Swedes and Middle Easterners; analysed differences within and between the groups and analysed differences in 25-hydroxyvitamin D [25(OH)D] levels between the groups. 522 patients responded to a health questionnaire that included items on sexual health: 225 Middle Easterners from Iran, Iraq, and Turkey and 297 Swedes. Logistic regression was used to calculate the odds ratio (OR). Middle Easterners reported less sexual dysfunction than Swedes, and 75.8% of them and 18.9% of Swedes presented a 25(OH)D of < 50 nmol/L. The crude OR for reporting sexual dysfunction was 70% higher in Swedes compared to Middle Easterners (OR 1.70, 95% CI 1.15–2.50). This OR remained significant after adjustment for age, gender, waist circumference, and reported sexual desire. However, the significance disappeared after additional adjustment for 25(OH)D. In both groups, more females than males reported insufficient sexual desire. More female Middle Easterners reported sex life dissatisfaction. More female Swedes reported sexual dysfunction. Vitamin D could explain an association between gender and sex life dissatisfaction in Middle Easterners, and age could explain an association between gender and sexual dysfunction in Swedes. Age, waist circumference, and 25(OH)D levels were significant covariates in the logistic regression models. Results from the present study suggest that 25(OH)D variation partly explains differences in sexual dysfunction between the groups and between genders within the groups. Vitamin D therapy should be investigated to determine if these results are clinically useful. [ABSTRACT FROM AUTHOR]

The article focuses on a male-only therapy group that has been functioning for the last nine years in the Middle East, in Iran. The group has a permanent main female therapist and temporary, mostly female trainee cotherapists. We explore culturally specific factors that we believe impact expressions of aggression in the group. These factors include the Iranian gender segregation culture, the ideal of masculinity relating to the concept of "Gheirat" (moral vigilance), the legal acceptance of multiple wives in Iran (which often leads to family instability), and the cultural belief about the uncontrollability of sexual desires in men. We also comment on the role of a common dynamic in Iranian families, in which the relationships between mothers and sons are usually overwhelming while the emotional relationships between parents are somehow restrained. We close by discussing future directions for this area of study as well as by proposing interventions therapists may consider when encountering related group dynamics. [ABSTRACT FROM AUTHOR]

Context: One of the changes that occur in a person and lead to a change in the patient's sexual desire is chronic diseases, including spinal cord injury (SCI). Objectives: This study aimed to evaluate the epidemiology of sexual dysfunction (SD) in patients with SCI in Iran by a systematic review and meta-analysis. Methods: In the present systematic review and meta-analysis, using the keywords "spinal cord injury", "sexual dysfunction", and "Iran" a list of related articles were extracted from national and international databases. The search was conducted by two researchers in the national databases (SID, Magiran, and Irandoc) and international databases (Web of Science, PubMed, and Scopus). The necessary data were collected using a specialized checklist and analyzed using CMA v.2.0 software. Results: The result showed 183 articles were extracted in the initial search, and after reviewing the articles, six articles were included in the systematic review and meta-analysis stage. The prevalence of SD in patients with SCI was equal to 45.9%, 95% (CI: 30.2 - 62.4). Conclusions: The prevalence of SD and sexual dissatisfaction in patients with SCI was reported to be high. For this reason, it is suggested to do necessary interventions to improve the sexual satisfaction of these patients. [ABSTRACT FROM AUTHOR]

Introduction: One of the causes of dissatisfaction between couples is sexual dysfunction that sometimes leads to divorce. The present systematic study was conducted to evaluate the factors affecting sexual dysfunction and divorce in Iran. Method: A comprehensive search, including keywords of sexual dysfunction, emotional divorce, breakaway, separation, conflict, and Iran, was conducted on the databases of Scopus, MEDLINE/PubMed, CINAHL, Web of Science, Magiran, IranMedex, and SID. Out of the total number of reviewed articles, 16 articles met the inclusion criteria. No time limit was considered for our research and all published articles up to November 2021 were reviewed. Results: Based on the results of the present study, in all of the reviewed articles, sexual problems and dissatisfaction were among the effective factors in the occurrence or request of a formal divorce or an emotional divorce. The data also demonstrated that weakness in arousal and sexual desire, weakness in sexual function, sexual disorders, orgasm problems, and pain were among the problems of people on the verge of divorce. Conclusion: Due to the importance of this issue, recognizing the effective and influential factors of divorce is one of the priorities of mental health. Dissatisfaction with sexual relations in both or one of the spouses is found to be one of the most important factors involved in divorce. If there are problems such as sexual dysfunction between the couples, they may still live together due to cultural and social conditions; however, they may experience emotional divorce. Therefore, there is an urgent need for effective counseling and treatment programs in this regard. [ABSTRACT FROM AUTHOR]

Background: Women may experience different problems in every aspect of their sexual life throughout their lives; therefore, it is essential to check women's sexual health and try to improve it. The present research aims to assess core stability trainings on postpartum mothers' sexual desire. Materials and Methods: This quasi-experimental research was conducted by random sampling on 72 mothers who referred to comprehensive health centers in Isfahan in 2019 in postpartum period. The samples were divided into experimental and control groups by random placement method (blocking). Core stability exercises were performed in the experimental group for 24 sessions. The demographic questionnaire and Female Sexual Function Index (FSFI) were filled out in two stages (before and one month after the intervention) by the samples, and the data were analyzed by Mann-Whitney, independent t-test, paired t-test, Chi-square. Results: The result of this study showed that the average score of the sexual desire after intervention in the experimental group was significantly higher than that in the control group (p = 0.03). The average score of the sexual desire after the intervention in the experimental group was significantly higher than that before the intervention (p < 0.001). The average scores of the sexual desire before and after the intervention in the control group were not significantly different (p = 0.40). Conclusions: Eight weeks of core stabilization exercises can improve endurance of the pelvic floor muscles and the central part of the body, subsequently promoting females' sexual desire. The findings of this study can be considered in the fields of education, health, clinical, and policy. [ABSTRACT FROM AUTHOR]

Objective: Infertility has a significant impact on the sexual function of couples. The use of herbal medicine has been highly important throughout the history of medicine. The present study was conducted to evaluate the effect of date palm on sexual function of infertile couples. Results: The present study was a double-blind, placebo-controlled clinical trial conducted on infertile women and their husbands who referred to infertility clinics in Iran in 2019. The intervention group was given a palm date capsule and the control group was given a placebo. Data were collected through female sexual function index and International Index of Erectile Function. The total score of sexual function of females in the intervention group increased significantly from 21.06 ± 2.58 to 27.31 ± 2.59 (P < 0.0001). Also, other areas of sexual function in females (arousal, orgasm, lubrication, pain during intercourse, satisfaction) in the intervention group showed a significant increase compared to females in the control group, which was statistically significant (P < 0.0001). All areas of male sexual function (erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction) significantly increased in the intervention group compared to the control group (P < 0.0001). The present study revealed that 1-month consumption of date palm has a positive impact on the sexual function of infertile couples. Trial registration The trial was retrospectively registered in the Iranian registry of clinical trials at 2020-10-07 (https://www.irct.ir/trial/51339; registration number: IRCT20200925048834N1) [ABSTRACT FROM AUTHOR]

In the aftermath of Iran's Islamic revolution, the representation and expression of women's sexuality have undergone stringent official censorship. Zoya Pirzad stands out among Iranian female authors for subtly challenging the Islamic regime's censorship of Iranian women's bodies and sexuality in her writings. In Things We Left Unsaid (2012), while articulating the sexual desires of her protagonist, Pirzad adeptly employed indirect writing techniques to safeguard her work from censorship. This article delves into the author's nuanced literary techniques, including similes, metaphors, idioms, symbols, allusions, haptic perception, and the portrayal of bodily effects, as means to subvert Iran's official censorship. Pirzad employs these literary tactics to discreetly depict her protagonist's illicit sexual relationship, interwoven with the author's critique of the government's repressive policies on women's rights. To understand the intricate dance between the said and unsaid in Pirzad's work, this article draws upon the insights of affect theory. [ABSTRACT FROM AUTHOR]

Background: Internet dependency has become one of the 21st century dilemmas affecting different aspects of married life such as sexual relationships. Considering the importance of family in the Iranian society, this study aimed to determine how internet dependency is related to sexual desires and satisfaction among married clients of healthcare centers. Materials and Methods: This cross-sectional study was conducted on 326 married clients referred to healthcare centers in Tabriz City, Iran, between February and August 2019. Proportionate stratified random sampling was used based on the health complexes and the healthcare centers covered by them. One of the healthcare centers covered by each complex was selected randomly. The data collection tools included a demographic characteristics checklist, the Internet Addiction Test (IAT), the Index of Sexual Satisfaction (ISS), and the Hurlbert Index of Sexual Desire (HISD). The collected data were analyzed using the Pearson correlation coefficient test and multiple linear regression model. Results: The mean (SD) was 37.33 (15.37) for of internet dependency, 59.20 (17.27) for sexual desire, and 104.45 (22.81) for sexual satisfaction. There was a negative correlation between internet dependency and sexual satisfaction (r = -0.47, p < 0.001). This correlation remained significant (B = -0.41, df = 9, p < 0.001,) even when occupation (B = 3.66, p = 0.01), satisfaction with married life (B = 15.34, p < 0.001), and sexual desire (B = 0.60, p < 0.001) were adjusted as potential confounding factors. Conclusions: Internet dependency can cause a reduction in sexual desire and sexual satisfaction. Designing educational interventions in healthcare centers is recommended to manage the use of internet and to inform clients about the effects that internet dependency may have. [ABSTRACT FROM AUTHOR]

Background: Various socio-demographic factors have been introduced as the determinants of Low Sexual Desire (LSD), but whether these variables can also contribute to the Hypoactive Sexual Desire Disorder (HSDD), remains uncertain. In this study, we sought to identify the socio-demographic determinants of LSD and HSDD in Iranian women of reproductive age.Methods: This was a population-based, cross-sectional study of 1000 married Iranian women of reproductive age (16-49 years) who met the inclusion criteria. The participants were chosen using the systematic random sampling method from all the healthcare centres in the city of Sari, Iran. LSD was defined as a score no higher than 33 on the Sexual Interest and Desire Inventory-Female (SIDI-F). The sexually-related personal distress was considered as a score of at least 11.0 on the Female Sexual Distress Scale-Revised (FSDS-R), and HSDD was determined based on the sum of those scores. Descriptive statistics were used to describe the socio-demographic characteristics and a chi-square test was run for data analysis using grouping variables. Multivariate logistic regression test was also employed to adjust the effect of confounding variables.Results: The mean score of sexual interest/desire among women was 30.6 ± 10.5. After adjusting the effect of confounding variables, logistic regression showed that socio-demographic variables including age at first intercourse, length of marriage and the level of satisfaction with income were significantly associated with both LSD and HSDD (P < 0.01). While advancing age (P < 0.001) and body mass index (P < 0.01) were just predictors of LSD.Conclusion: Some socio-demographic factors could predict LSD in women, while they were not associated with HSDD. In other words, some factors associated with LSD do not instigate sexually-related personal distress, which is one of the criteria necessary for the diagnosis of HSDD. [ABSTRACT FROM AUTHOR]

Objective: Hypoactive Sexual Desire Disorder (HSDD) among women is a complicated one which is created by various factors playing roles. One of the potential concerns related to Body Image (BI) is lack of sexual appeal in women. Body Image is often described as what a person perceives of their body encompassing the biological, psychological and social factors. The present research pursues the goal to investigate the association between BI and HSDD among the reproductive age women in Iran. Materials and methods: The current study is a cross-sectional (descriptive -analytical) research done on 1000 reproductive age included woman (15-49 years), performed by systematic random sampling method. The data collection tool includes the socio-demographics and the sexual desire scale in addition to the revised sexual distress scale to measure HSDD completed as self-report by the samples. Univariate and multivariate regression tests have been used in order to analyze the data. Results: The mean ± SD age of the women participating in the study was 32.09 ± 7.33. Having adjusted the confounder variables' effect by logistic regression multivariate analysis; the odd ratio for HSDD has been analyzed. The findings suggested that the odd ratio for HSDD in those not satisfied or slightly feeling fulfilled with their BI has been OR: 4.2 (95% CI: 1.98-9.05) and OR: 3.9 (95% CI: 2.29-6.65), respectively, times more than the ones highly satisfied with their body image. Conclusion: The present study results indicate that being dissatisfied with BI is a determinant factor of HSDD that is more probable in the people with negative image of their body structure and feeling lack of bodily appeal. Thus it is imperative to pay attention to this factor when analyzing HSDD. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of a structured educational package based on ADDIE (analysis, design, development, implementation, evaluation) to reduce sexual dysfunction during pregnancy.Methods: A randomized controlled trial study among pregnant women attending prenatal clinics in Tehran, Iran, from October 2017 to September 2018. The implementation group received the structured educational package; the control group received training on breastfeeding and normal delivery. The outcome measure was changes in total and domain scores of the Female Sexual Function Index (FSFI) questionnaire before and after the intervention; the groups were compared by repeated-measures analysis of variance (ANOVA).Results: Overall, 70 women completed the study: 36 in the intervention group and 34 in the control group. Sexual desire (P=0.019), arousal (P=0.001), lubrication (P=0.001), orgasm (P=0.001), satisfaction (P=0.007), and total FSFI score (P<0.001) improved significantly in the intervention group as compared with the control group. However, there was no difference in sexual pain after the intervention (P=0.78).Conclusion: The structured educational package was found to reduce sexual dysfunction by improving knowledge of and attitudes toward the physical and psychologic changes that occur during pregnancy among Iranian women attending routine prenatal care visits as part of a healthcare center's program. Iranian Registry of Clinical Trials: IRCT20140907019077N14. [ABSTRACT FROM AUTHOR]

Objectives: Sexual dysfunction is one of the most serious problems that may occur in the postpartum period and can lead to physical, psychological, and social adverse effects in women. The type of delivery is one of the factors that may affect the prevalence of sexual disorders in this period. The present study evaluated the relationship between the mode of delivery and women's sexual function in 6 months and one year after the delivery. Materials and Methods: The participants of this cohort study included all nulliparous mothers aged 18 to 35 years, who referred to healthcare centers in Sanandaj, the capital city of Kurdistan province, Iran. The sample size for the vaginal delivery with episiotomy and cesarean section (C-section) was 68 women. Sexual function was evaluated using the Female Sexual Function Index (FSFI) 6 and 12 months after the delivery. Results: There was no significant difference between the two groups before pregnancy regarding women's sexual function (P = 0.9) while both types of deliveries resulted in a significant reduction in sexual function 6 months after the childbirth. In addition, vaginal delivery reduced sexual function more than C-section. The mean scores of sexual function were 24.4 for the vaginal delivery group and 26.8 for cesarean delivery (P = 0.01). Finally, women in the C-section group had significantly higher levels of sexual desire one year after the delivery (P = 0.03). Conclusions: Overall, sexual function in the C-section group was better than the vaginal delivery group 6 months after the delivery. However, this difference was only significant in the domain of sexual desire one year after the childbirth. [ABSTRACT FROM AUTHOR]

Female genital cosmetic surgery (FGCS) is increasingly becoming popular among Iranian women. This study aimed to assess the relationship between sexual quality of life, female genital self-image, body image and sexual function, in women requesting genital cosmetic surgery. A sample of 50 women seeking genital cosmetic surgery without any medical indications and 100 women as comparison group participated in the study. Participants were selected by convenience sampling. Hierarchical regression analysis was performed by four steps to indicate factors that contribute to the female sexual quality of life. The results showed that education, age, duration of marriage, female genital self-image, body image, sexual function jointly accounted for 60% of the variance in sexual quality of life score between two groups. Of these, sexual function and body image showed the greatest coefficients (β = 0.493 and 0.282, respectively) and significant relationship with sexual quality of life score, p < 0.001. This study is the first investigation that examines FGCS in Iran. The findings suggest that there is association between seeking cosmetic vaginal surgery and female sexual functioning and body image, and that these are related to female sexual quality of life. Perhaps improving these factors might lead to the decreased unnecessary female genital cosmetic surgeries. [ABSTRACT FROM AUTHOR]

Background: Sexual desire has biological, individual, interpersonal, and social dimensions. The question raised here is whether being a woman or a man influences sexual desire or whether gender differences contribute to it. Objectives: This study aimed at exploring married women's and men's experiences regarding the concept of sexual desire. Methods: This study conducted by a qualitative design and with a thematic analysis method. Data were collected using semi structured-interviews (with an equal number of men and women) chosen through a purposeful sampling method. After being conducted, each interview was transcribed verbatim and read several times to achieve the sense of the whole and then, the key terms were highlighted as codes. After the initial classification of the codes, subthemes and main themes gradually appeared. Results: Two main themes were developed as follows: "feeling of arousal with the goal of achieving orgasm" and "individual conditions and relational skills strengthening sexual desire." Conclusions: Participants considered physical, psychological, and interpersonal dimensions of sexual desire. They mostly intended sexual intercourse and orgasm during the feeling of sexual desire. The skills of couples to interact with each other and physical and psychological readiness for an individual to have sexual relationships strengthened sexual desire. Any evaluation and treatment in the field of sexual desire should be comprehensive and consider all contextual, individual, and interpersonal aspects of each society. [ABSTRACT FROM AUTHOR]

Understanding physical, psychological and social needs is the basis for disease management. The purpose of this study was to investigate the informational, psychological, and social needs of patients undergoing chemotherapy. The present study is a descriptive-correlational one conducted on 400 patients undergoing chemotherapy visiting a teaching hospital in Northwest Iran. The data collection instrument consisted of three sections, including the demographic information of patients, a researcher-made questionnaire to determine the informational needs of patients, and a Psychosocial Needs Index (PNI) provided to patients while receiving chemotherapy. Data were analyzed by descriptive and inferential statistics in SPSS 21 version. The results showed that the mean score of patients' informational needs was high and the mean score of their psychosocial needs was moderate. Regarding the informational dimension, the highest level of need was reported for the item "I need to be aware of things to help me recover from my disease"; in the psychosocial dimension, the highest level of need belonged to the psychological dimension with the item "I need help to reduce my family's concerns about my illness"; in the physical and daily activity dimension, the highest level of need was related to item "I need help to reduce fatigue and gain energy"; in the care and support dimension, the highest level of need belonged to the item "I need the timely attendance of medical staff in case of physical needs and complications"; and finally, in the sexual dimension, the highest level of need was reported for the item " I need help to control changes in my sexual desire". The findings showed that patients with cancer have extensive needs after the diagnosis of the disease and during chemotherapy, and understanding these needs is important in planning care for these patients. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy is a very sensitive period that is often accompanied by changes in the couple's sexual relationship due to various physical and psychological changes. Aim: The purpose of this study was to evaluate men's sexuality and their attitude toward sexual relationship during their wive's pregnancy. Materials and Methods: The present cross-sectional study was conducted on the husbands of 272 pregnant women who attended healthcare centers of Jahrom, Iran, from March 2016 to May 2016. International Index of Erectile Function (IIEF) questionnaire was used to assess the sexual function. T-test utilised to compare overall satisfaction score with characteristics of the participants, ANOVA test used in order to compare domains of male sexual function with pregnancy trimesters. Besides, p-value <0.05 was considered as statistically significant. Results: The husband's mean age was 32.57±6.12 years. Of the total 62, 81, and 129 subjects were in their first, second and third trimesters, respectively. Comparison of the first, second and the third trimesters revealed a significant difference in the scores of all IIEF domains. Among the study subjects, 82.7% had erectile dysfunction, 84.2% had orgasmic dysfunction, 92.64% had sexual desire dysfunction, 95.6% had intercourse dissatisfaction, and 80.1% had overall dissatisfaction. Almost 62.2% of the men displayed a negative attitude towards sexuality and only 11% men had positive attitude. Conclusion: The results of the present study showed that sexual disorders were highly prevalent among men. The most prevalent sexual dysfunction was desire disorder and intercourse dissatisfaction. Since, attitude towards sexuality affected their general sexual behaviour during pregnancy, it is crucial to provide proper consultation regarding sexual relations in prenatal care services. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate women''s perception of sexual activity during pregnancy in Shahroud, Iran. Methods: Data were gathered during 4 semi-structured group interviews with 33 pregnant women attending 2 obstetric outpatient clinics of a teaching hospital in Shahroud. The interviewers taped the interviews, coded and categorized their content, and performed a qualitative content analysis. Results: Most women reported a decrease in sexual desire and frequency of intercourse during pregnancy (69.7% and 81.8%, respectively). Sexual desire, however, increased for 18.2% of the women. Some felt that accepting intercourse prevented spousal infidelity, but 65.2% worried that it might cause injury to the fetus. Only 24.2% received information on the advisability of sexual activity during pregnancy from their physicians or midwives, and the other 75.8% sensed that they should discuss the topic with a professional but were not comfortable starting the conversation. Conclusion: Along with excessive anxiety, insufficient information is the major reason why sexual intercourse is often considered dangerous, and sometimes avoided, during pregnancy in Iran. Healthcare professionals, especially midwives, should educate and counsel women, and reassure them that intercourse is safe in women with healthy pregnancies. [Copyright &y& Elsevier]