Search

Your search keyword '"Nappi RE"' showing total 436 results
Start Over Author "Nappi RE"
436 results on '"Nappi RE"'

1. Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy

Author

Cucinella L, Tiranini L, Cassani C, Martella S, and Nappi RE

Subjects
genitourinary syndrome of menopause, gsm, vaginal laser, breast cancer, vulvovaginal atrophy, vva., Gynecology and obstetrics, RG1-991
Abstract

Laura Cucinella,1,2 Lara Tiranini,1,2 Chiara Cassani,1,3 Silvia Martella,4 Rossella E Nappi1,2 1Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; 2Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy; 3Unit of Obstetrics and Gynecology, IRCCS San Matteo Foundation, Pavia, Italy; 4Unit of Preventive Gynecology, IRCCS European Institute of Oncology, Milan, ItalyCorrespondence: Rossella E Nappi, Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Piazzale Golgi 2, Pavia, 27100, Italy, Tel +390382501561, Fax +390382516176, Email nappi@rossellanappi.comAbstract: Genitourinary syndrome of menopause (GSM) is a frequent consequence of iatrogenic menopause or anti-estrogenic adjuvant therapies in breast cancer survivors (BCSs). GSM may profoundly affect sexual health and quality of life, and a multidimensional unique model of care is needed to address the burden of this chronic heterogeneous condition. Severe symptoms may be insufficiently managed with non-hormonal traditional treatments, such as moisturizers and lubricants, recommended as the first-line approach by current guidelines, because concerns exist around the use of vaginal estrogens, particularly in women on aromatase inhibitors (AIs). Vaginal laser therapy has emerged as a promising alternative in women with GSM who are not suitable or do not respond to hormonal management, or are not willing to use pharmacological strategies. We aim to systematically review current evidence about vaginal laser efficacy and safety in BCSs and to highlight gaps in the literature. We analyzed results from 20 studies, including over 700 BCSs treated with either CO2 or erbium laser, with quite heterogeneous primary outcomes and duration of follow up (4 weeks– 24 months). Although evidence for laser efficacy in BCSs comes mostly from single-arm prospective studies, with only one randomized double-blind sham-controlled trial for CO2 laser and one randomized comparative trial of erbium laser and hyaluronic acid, available data are reassuring in the short term and indicate effectiveness of both CO2 and erbium lasers on the most common GSM symptoms. However, further studies are mandatory to establish long-term efficacy and safety in menopausal women, including BCSs.Keywords: genitourinary syndrome of menopause, GSM, vaginal laser, breast cancer, vulvovaginal atrophy, VVA

Published
2023

2. Cycle control with an extended-regimen oral contraceptive combining levonorgestrel and ethinyl estradiol that includes continuous low-dose ethinyl estradiol instead of the traditional hormone-free interval

Author

Nappi RE, Lobo Abascal P, Hsieh J, and Micheletti M

Subjects
Combined oral contraception (COC), menstrual cycle, 91-day cycle, extended-regimen COC, Gynecology and obstetrics, RG1-991
Abstract

Rossella E Nappi,1 Paloma Lobo Abascal,2 Jennifer Hsieh,3 Marie-Christine Micheletti4 1Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; 2Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain; 3Teva Branded Pharmaceutical Products R&D, Inc., Malvern, PA, USA; 4Teva Europe Women’s Health Medical Affairs, Amsterdam, the Netherlands Purpose: To evaluate scheduled and unscheduled bleeding and spotting over 1 year of treatment with 91-day extended-regimen combined oral contraception (COC) providing continuous low-dose ethinyl estradiol (EE) in place of the traditional 7-day hormone-free interval (HFI).Patients and methods: This post hoc analysis of a multicenter, open-label, 1-year, Phase 3 study of extended-regimen COC with 30 µg EE/150 µg levonorgestrel (LNG) for 84 days and EE 10 µg for 7 days included 799 sexually active, adult women who completed at least one 91-day cycle of therapy. Subjects recorded bleeding and spotting episodes daily using electronic diaries. Logistic regression analyses are reported as ORs with 95% CIs.Results: There was a 10% increase (OR =1.102; 95% CI: 1.006–1.206) in the likelihood of reporting no scheduled bleeding for each additional 91-day cycle completed. From the third 91-day cycle, more than one fifth of women reported no scheduled bleeding (third cycle =23% [121/533]; fourth cycle =22% [97/446]). Among women who reported no scheduled bleeding at Cycle 1 (136/758 [18%]), ≥45% showed sustained lack of scheduled bleeding in later cycles. There were increases of 53% (OR =1.531; 95% CI: 1.393–1.683) and 31% (OR =1.307; 95% CI: 1.205–1.418) in the likelihood of reporting 0 to ≤6 days vs >6 days of unscheduled bleeding and spotting, respectively, for each additional 91-day cycle. By Cycle 2, more than 80% of women reported no unscheduled bleeding or ≤6 days of unscheduled bleeding during each 91-day cycle.Conclusion: Improved cycle control with decreased bleeding over time was shown during extended-regimen COC with 30 µg EE/150 µg LNG for 84 days and continuous low-dose EE instead of the traditional 7-day HFI. Women considering this regimen should be informed that those who complete at least one 91-day COC cycle will likely experience less bleeding/spotting in future cycles. Keywords: combined oral contraception, menstrual cycle, 91-day cycle, extended-regimen COC

Published
2017

3. Noncontraceptive benefits of the estradiol valerate/dienogest combined oral contraceptive: a review of the literature

Author

Nappi RE, Serrani M, and Jensen JT

Subjects
Gynecology and obstetrics, RG1-991
Abstract

Rossella E Nappi,1 Marco Serrani,2 Jeffrey T Jensen3 1Department of Obstetrics and Gynecology, Research Centre for Reproductive Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy; 2Global Medical Affairs Women's Healthcare, Bayer HealthCare Pharmaceuticals, Berlin, Germany; 3Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA Abstract: Combined oral contraceptives formulated to include estradiol (E2) have recently become available for the indication of pregnancy prevention. A combined estradiol valerate and dienogest pill (E2V/DNG), designed to be administered using an estrogen step-down and a progestin step-up regimen over 26 days of active treatment followed by 2 days of placebo (26/2-day regimen), has also undergone research to assess the potential for additional noncontraceptive benefits. Randomized, placebo-controlled studies have demonstrated that E2V/DNG is an effective treatment for heavy menstrual bleeding – a reduction in median menstrual blood loss approaching 90% occurs after 6 months of treatment. To date, E2V/DNG is the only oral contraceptive approved for this indication. Comparator studies have also demonstrated a reduction in hormone withdrawal-associated symptoms in users of E2V/DNG compared with a conventional 21/7-day regimen of ethinylestradiol/levonorgestrel. Other potential noncontraceptive benefits associated with E2V/DNG, like improvement in dysmenorrhea, sexual function, and quality of life, are comparable with those associated with other combined oral contraceptives and are discussed further in this review. Keywords: heavy menstrual bleeding, hormone withdrawal-associated symptoms, quality of life

Published
2014

4. Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy

Author

Parish SJ, Nappi RE, Krychman ML, Kellogg-Spadt S, Simon JA, Goldstein JA, and Kingsberg SA

Subjects
Gynecology and obstetrics, RG1-991
Abstract

Sharon J Parish,1 Rossella E Nappi,2 Michael L Krychman,3 Susan Kellogg-Spadt,4 James A Simon,5 Jeffrey A Goldstein,6 Sheryl A Kingsberg7 1Albert Einstein College of Medicine, Bronx, NY, USA; 2Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo University, University of Pavia, Pavia, Italy; 3Southern California Center for Sexual Health and Survivorship Medicine and Clinical Faculty University of California Irvine, Newport Beach and Irvine, CA, USA; 4Pelvic and Sexual Health Institute, Philadelphia, PA, USA; 5Obstetrics and Gynecology, George Washington University, Washington, DC, USA; 6Novo Nordisk Inc, Princeton, NJ, USA; 7Departments of Reproductive Biology and Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA Abstract: Several recent, large-scale studies have provided valuable insights into patient perspectives on postmenopausal vulvovaginal health. Symptoms of vulvovaginal atrophy, which include dryness, irritation, itching, dysuria, and dyspareunia, can adversely affect interpersonal relationships, quality of life, and sexual function. While approximately half of postmenopausal women report these symptoms, far fewer seek treatment, often because they are uninformed about hypoestrogenic postmenopausal vulvovaginal changes and the availability of safe, effective, and well-tolerated treatments, particularly local vaginal estrogen therapy. Because women hesitate to seek help for symptoms, a proactive approach to conversations about vulvovaginal discomfort would improve diagnosis and treatment. Keywords: health care professional, hypoactive sexual desire disorder, local vaginal estrogen therapy, quality of life, urinary tract infection, vulvovaginal atrophy

Published
2013

5. Sexual functioning in women with functional hypothalamic amenorrhea: exploring the relevance of an underlying polycystic ovary syndrome (PCOS)-phenotype

Author

Barbagallo, F, Pedrielli, G, Bosoni, D, Tiranini, L, Cucinella, L, Calogero, Ae, Facchinetti, F, and Nappi, Re

Subjects
Endocrinology, Sexual function, Endocrinology, Diabetes and Metabolism, Mood, Androgens, Polycystic ovary syndrome, Functional hypothalamic amenorrhea
Abstract

Purpose To study sexual function and distress in women with functional hypothalamic amenorrhea (FHA) compared to women with FHA and an underlying polycystic ovary syndrome (PCOS)-phenotype, considering also their psychometric variables. As a secondary aim, we explored the relationship between sexual functioning and hormonal milieu in these women. Methods This is a retrospective cross-sectional study conducted on 36 women with typical FHA and 43 women with FHA + PCOS-phenotype. The following validated psychometric questionnaires were administered: Female Sexual Functional Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Body Attitude Test (BAT), Bulimia Investigation Test (BITE), State Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Multidimensional Perfectionism Scale (MPS). Available hormones to formulate FHA diagnosis in the standard routine were considered. Results Women with typical FHA reported a significantly lower FSFI total score than women with FHA + PCOS-phenotype (95% CI for median 16–21.3 vs. 21.1–24.1, p = 0.002), whereas the FSDS-R score was similar in the two groups (95% CI for median 6–16 vs. 6–16.3). No statistically significant differences were evident in body attitude, state and trait anxiety, depression, bulimic risk, and perfectionism between the two groups, confirming the two FHA groups were superimposable from a psychometric perspective. State anxiety correlated negatively with the FSFI total score in both typical FHA (rho: − 0.33, p = 0.05) and FHA + PCOS-phenotype (rho: − 0.40, p = 0.009). In the entire study population, a positive correlation was found between luteinizing hormone, androstenedione, and 17ß-estradiol and the total FSFI score (rho: 0.28, p = 0.01; rho: 0.27, p = 0.01, rho: 0.27, p = 0.01, respectively). Conclusion Women with FHA showed a very high rate of sexual symptoms as part of their condition, but those with a typical diagnosis displayed a more severe sexual impairment as compared with the FHA + PCOS-phenotype, in spite of a similar psychometric profile. Sexual distress was equally present in both groups (approximately 4 out of 10 women). Further studies should be designed to investigate the potential role of sex hormones, mainly LH-driven androstenedione, in influencing women’s sexual functioning.

Published
2023

7. Impact of vulvovaginal atrophy of menopause: prevalence and symptoms in Italian women according to the EVES study

Author

Nappi RE, Seracchioli R, Salvatore S, Cagnacci A, Di Paolantonio T, Busacca M, investigators of the EVES Study., Nappi RE, Seracchioli R, Salvatore S, Cagnacci A, Di Paolantonio T, Busacca M, and investigators of the EVES Study.

Subjects
medicine.medical_specialty, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Vaginal Diseases, prevalence, sexual function, 030209 endocrinology & metabolism, DIVA, Vulva, EQ-5D, gynecological exam, Vulvovaginal atrophy, Endocrinology, Obstetrics and Gynecology, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Vaginal disease, Quality of life, Obstetrics and gynaecology, Surveys and Questionnaires, Humans, Medicine, Aged, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Middle Aged, medicine.disease, Postmenopause, Menopause, Diabetes and Metabolism, Cross-Sectional Studies, medicine.anatomical_structure, Italy, Vagina, Quality of Life, Female, Vulvar Diseases, Symptom Assessment, business, Sexual function
Abstract

This cross-sectional study included postmenopausal women, aged 45-75 years, with the aim to assess the presence of vulvovaginal atrophy (VVA) confirmed by a clinical assessment in the Italian population attending menopausal/gynecological centers. Apart from baseline variables, women scored vaginal, vulvar and urinary VVA symptoms. Impact of VVA on sexual function and quality of life (QoL) was assessed thorough EuroQoL questionnaire (EQ5D3L), Day-to-Day Impact of Vaginal Aging (DIVA), Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-revised (FSDS-R). A physical examination was carried out in accordance with routine gynecological practice. VVA was confirmed in 90% of the 1226 evaluable patients (aged 59.0 ± 7.3 years). The prevalence of postmenopausal women with VVA confirmed by gynecological clinical assessment was 75.3%. The patients with VVA confirmed (n = 926) had more severe symptoms (p

Published
2019

10. Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH)

Author

Sacco, S, Merki-Feld, GS, Aelig;gidius, KL, Bitzer, J, Canonico, M, Gantenbein, AR, Kurth, T, Lampl, C, Lidegaard, O, MacGregor, EA, Maassen van den Brink, Antoinette, Mitsikostas, DD, Nappi, RE, Ntaios, G, Paemeleire, K, Sandset, PM, Terwindt, GM, Vetvik, KG, Martelletti, P, Sacco, S, Merki-Feld, GS, Aelig;gidius, KL, Bitzer, J, Canonico, M, Gantenbein, AR, Kurth, T, Lampl, C, Lidegaard, O, MacGregor, EA, Maassen van den Brink, Antoinette, Mitsikostas, DD, Nappi, RE, Ntaios, G, Paemeleire, K, Sandset, PM, Terwindt, GM, Vetvik, KG, and Martelletti, P

Published
2018

11. Hormonal contraceptives and risk of ischemic stroke in women with migraine: a consensus statement from the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESC)

Author

Sacco, S, Merki-Feld, GS, Aelig;gidius, KL, Bitzer, J, Canonico, M, Kurth, T, Lampl, C, Lidegaard, O, MacGregor, EA, Maassen van den Brink, Antoinette, Mitsikostas, DD, Nappi, RE, Ntaios, G, Sandset, PM, Martelletti, P, Sacco, S, Merki-Feld, GS, Aelig;gidius, KL, Bitzer, J, Canonico, M, Kurth, T, Lampl, C, Lidegaard, O, MacGregor, EA, Maassen van den Brink, Antoinette, Mitsikostas, DD, Nappi, RE, Ntaios, G, Sandset, PM, and Martelletti, P

Published
2017

12. Counseling on vaginal delivery of contraceptive hormones: implications for women's body knowledge and sexual health

Author

Nappi, Re, Italian Nuvaring Study Group, Benedetto, Chiara, Cagnacci, A, De Seta, F, Genazzani, Ar, Guida, M, Michieli, R, Moscarini, M, Primiero, F, Russo, N., DI BENEDETTO, Claudia, Cagnacci, A, DE SETA, Francesco, Genazzani, Ar, Guida, M, Michieli, R, Moscarini, M, Primiero, F, Russo, N., Nappi, Re, Benedetto, C, De Seta, F, and Russo, N

Subjects
Counseling, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Population, Context (language use), Hormonal contraception, Vaginal ring, Endocrinology, Contraceptive Agents, Contraceptive Agents, Female, Medicine, Humans, education, Contraception Behavior, Reproductive health, Vaginal flora, Gynecology, education.field_of_study, Practice, Intravaginal, business.industry, Vaginal delivery, Health Knowledge, Obstetrics and Gynecology, Administration, Intravaginal, Contraception, Female, Hormones, Reproductive Health, Sexuality, medicine.anatomical_structure, Family planning, Family medicine, Attitudes, Administration, Vagina, pills, business
Abstract

Healthcare providers (HCPs) have an important role in helping women select the contraceptive method that best matches their needs and lifestyle. Recent surveys outline the need of women to be informed about all available choices, including the newest methods (particularly those not requiring daily administration), such as vaginal contraception.The most relevant publications on combined contraceptive vaginal ring are revised in the context of counseling as an opportunity to empower women in term of vaginal health and sexual functioning.HCPs should explain the main characteristics of the combined contraceptive vaginal ring including the anatomical and physiological implications that make the vagina an ideal route of hormonal administration and the basic notions about functional modifications of the vagina during reproductive life. Clinical data on the vaginal ring should be summarized with regard to efficacy, tolerability, pharmacokinetics, cycle control and user acceptability, including recent findings on extra-contraceptive benefits (also compared to other hormonal contraceptives) on the vaginal flora and on sexual function.Vaginal contraception offers various benefits and should always be discussed during contraceptive counseling. An open dialogue about vaginal contraception will also help enhance body knowledge and sexual health.

Published
2013

16. Updated IMS recommendations on postmenopausal hormone therapy and preventive strategies for midlife health

Author

Sturdee, Dw, Pines, A, International Menopause Society Writing Group, Archer, Df, Baber, Rj, Barlow, D, Birkhäuser, Mh, Brincat, M, Cardozo, L, de Villiers TJ, Gambacciani, M, Gompel, Aa, Henderson, Vw, Kluft, C, Lobo, Ra, Maclennan, Ah, Marsden, J, Nappi, Re, Panay, N, Pickar, Jh, Robinson, D, Simon, J, Sitruk Ware RL, Albertazzi P, Stevenson J. C., Berry, E, Böcker, W, Burger, H, Christiansen, C, Foidart, Jm, Gambaccian, M, Genazzani, Andrea, Huang, Ke, Huber, J, Limpaphayom, K, Lumsden, Ma, Maclennan, A, Murphy, A, Naftolin, F, Nappi, Ra, Palacios, S, Rizzoli, R, Rosano, G, Russo, J, Samsioe, G, Schneider, Hp, Shapiro, S, Sitruk Ware, R, Skouby, S, Stevenson, Jc, and Sturdee, D. W.

Subjects
Gerontology, medicine.medical_specialty, Genital Neoplasms, Female, medicine.medical_treatment, Health Behavior, Osteoporosis, Alternative medicine, Breast Neoplasms, Health Promotion, Risk Assessment, Quality of life, Humans, Postmenopausal Hormone Replacement Therapy, Medicine, Drug Dosage Calculations, Osteoporosis, Postmenopausal, Ovarian Neoplasms, business.industry, Estrogen Replacement Therapy, Obstetrics and Gynecology, General Medicine, Middle Aged, medicine.disease, Postmenopause, Menopause, Health promotion, Cardiovascular Diseases, Critical Pathways, Quality of Life, Physical therapy, Women's Health, Female, Hormone therapy, business, Risk assessment
Abstract

The past decade has seen marked fluctuations in opinions concerning the merits and risks of postmenopausal hormone replacement therapy (HRT). In July 2002, menopause management faced a major turnin...

Published
2011

18. Italian position statement on hormone the national conference on menopause informa healthcare replacement therapy following and hormone replacement therapy, Villa Tuscolana, Frascati (Rome), May 8-9, 2007

Author

Genazzani, Ar, Gambacciani, M, Simoncini, Tommaso, Anniverno, R, Becorpi, Am, Biglia, N, Brandi, Ml, Guaschino, S, Lello, S, Massobrio, M, Melis, Gb, Mencacci, C, Modena, Mg, Nappi, C, Nappi, Re, Pecorelli, S, Petraglia, F, Rosano, Gm, Serra, Gb, Sismondi, P, Taddei, Stefano, and Tonelli, F.

Published
2007

22. Issues concerning the use of hormone replacement therapy and risk of fracture: a population-based, nested case-control study.

Author

Corrao, G, Zambon, A, Nicotra, F, Conti, V, Nappi, R, Merlino, L, CORRAO, GIOVANNI, ZAMBON, ANTONELLA, NICOTRA, FEDERICA, Nappi, RE, Merlino, L., Corrao, G, Zambon, A, Nicotra, F, Conti, V, Nappi, R, Merlino, L, CORRAO, GIOVANNI, ZAMBON, ANTONELLA, NICOTRA, FEDERICA, Nappi, RE, and Merlino, L.

Abstract

AIMS: To investigate the effect of duration, how recently it has been used, and age at start of hormone replacement therapy (HRT) and the risk of bone fracture. METHODS: A population-based, nested case-control study was conducted in Lombardia, Northern Italy. The 78,294 women aged 45-75 years who received at least one HRT prescription during 1998-2000 were followed until 2005. Cases were women who experienced bone fracture during follow-up. Up to six controls were randomly selected for each case from the cohort after matching for age and date of cohort entry. The odds ratio of fracture associated with the use of HRT was estimated by conditional logistic regression. RESULTS: One thousand one hundred and seventy-four cases and 6760 controls were included. Compared with women who took HRT for less than 2 months, those who were treated for more than 20 months had an odds ratio (OR) of 0.80 (95% confidence interval 0.65, 0.99). This risk reduction was still significant among current HRT users (OR 0.71, 95% CI 0.55, 0.90) and in women who began therapy at the age of 55-65 years (OR 0.63, 95% CI 0.42, 0.94) or 65-75 years (OR 0.56, 95% CI 0.32, 0.99). There was no statistical evidence of a protective effect for women who had stopped treatment more than 6 months previously or those who began HRT at the age of 45-55 years. CONCLUSIONS: HRT should be continued for long periods to achieve an optimal protection from fracture. The fracture reducing potential of HRT seems to disappear after a few months without treatment and might mainly act in women who begin therapy at older age.

Published
2008

23. Menopause hormone replacement therapy and cancer risk: an Italian record linkage investigation

Author

Corrao, G, Zambon, A, Conti, V, Nicotra, F, La Vecchia, C, Fornari, C, Cesana, G, Contiero, P, Tagliabue, G, Nappi, R, Merlino, L, CORRAO, GIOVANNI, ZAMBON, ANTONELLA, NICOTRA, FEDERICA, FORNARI, CARLA, CESANA, GIANCARLO, Nappi, RE, Merlino, L., Corrao, G, Zambon, A, Conti, V, Nicotra, F, La Vecchia, C, Fornari, C, Cesana, G, Contiero, P, Tagliabue, G, Nappi, R, Merlino, L, CORRAO, GIOVANNI, ZAMBON, ANTONELLA, NICOTRA, FEDERICA, FORNARI, CARLA, CESANA, GIANCARLO, Nappi, RE, and Merlino, L.

Abstract

BACKGROUND: The effects of persistence with hormone replacement therapy (HRT) on the risk of hospitalization for cancer and of the route of HRT administration on the risk of breast and colorectal cancer were explored in a large cohort study. PATIENTS AND METHODS: The 73 505 women residing in Lombardia (Italy), aged 45-75 years, who received at least one HRT prescription during 1998-2000 were followed until 2005. Among these, 3687 experienced cancer hospitalization. Proportional hazards model was fitted to estimate the association between cumulative HRT persistence and cancer risk. RESULTS: Compared with women who took HRT for <6 months, those exposed for >2 years showed hazard ratios (HR) of 0.78 (95% confidence interval 0.68-0.92) for colorectal cancer and 1.34 (1.13-1.58) for breast cancer. HR for breast cancer associated with long-term use of transdermal and oral HRT were, respectively, 1.27 (1.07-1.51) and 2.14 (1.43-3.21). CONCLUSIONS: Evidence that long-term use of HRT is associated with increased risk of breast cancer and decreased risk of colorectal cancer is supplied from this study from a southern European population. Our findings indicate that transdermal therapy might have lower effect than oral therapy in increasing breast cancer risk.

Published
2008

24. Persistence with oral and transdermal hormone replacement therapy and hospitalisation for cardiovascular outcomes

Author

Corrao, G, Zambon, A, Nicotra, F, Fornari, C, La Vecchia, C, Mezzanzanica, M, Nappi, R, Merlino, L, Cesana, G, CORRAO, GIOVANNI, ZAMBON, ANTONELLA, NICOTRA, FEDERICA, FORNARI, CARLA, MEZZANZANICA, MARIO, Nappi, RE, CESANA, GIANCARLO, Corrao, G, Zambon, A, Nicotra, F, Fornari, C, La Vecchia, C, Mezzanzanica, M, Nappi, R, Merlino, L, Cesana, G, CORRAO, GIOVANNI, ZAMBON, ANTONELLA, NICOTRA, FEDERICA, FORNARI, CARLA, MEZZANZANICA, MARIO, Nappi, RE, and CESANA, GIANCARLO

Abstract

BACKGROUND: The effect of persistence with transdermal and oral administrations of hormone replacement therapy (HRT) on the risk of hospitalisation for cardiovascular disease, and the role of income as potential confounder, were explored in a large population-based cohort study. METHODS: Seventy-eight thousand eight hundred and seventy-five women resident in the Italian Lombardy Region aged 45-65 years who received at least one HRT prescription during 1998-2000 were followed until December 2003. The 828 cohort members who experienced at least one hospitalisation for a circulatory system disease were identified from the Regional hospital discharge database. The Regional prescription drug database was used to assess cumulative persistence with hormone treatment during follow-up. Data on individual taxable income was also obtained for women resident in the city of Milan. A proportional hazards model was fitted to estimate the association between cumulative time-dependent persistence with HRT and cardiovascular risk. RESULTS: Compared with women who took HRT for less than 6 months, those exposed for more than 3 years to HRT as a whole, and to transdermal and oral HRT, respectively, showed hazard ratios of 0.65 (95% confidence interval: 0.45, 0.92), 0.53 (0.34, 0.82), and 1.15 (0.47, 2.79). CVD reducing potential of HRT disappeared when estimates were adjusted for income being hazard ratio associated with long-term use 0.94 (0.52, 1.71). CONCLUSIONS: Evidence that CVD risk associated with long-term hormone treatment varies according to the route of HRT administration, and that economic position confounds the effect of HRT on the risk of cardiovascular hospitalisation, is provided by the current study

Published
2007

36. Cutoff Score of the Sexual Interest and Desire Inventory-Female for Diagnosis of Hypoactive Sexual Desire Disorder.

Author

Clayton AH, Segraves RT, Bakish D, Goldmeier D, Tignol J, van Lunsen RH, Nappi RE, Wunderlich G, Kimura T, Lewis-D'Agostino DJ, and Pyke R

Subjects
COMPARATIVE studies, DIFFERENTIAL diagnosis, FEMALE reproductive organ diseases, LONGITUDINAL method, QUESTIONNAIRES, SEXUAL excitement, SEXUAL dysfunction, SECONDARY analysis, SEVERITY of illness index, RECEIVER operating characteristic curves, RESEARCH methodology evaluation, DESCRIPTIVE statistics
Abstract

Objective: To determine the most appropriate cutoff value for the Sexual Interest and Desire Inventory-Female (SIDI-F) score to discriminate between women with hypoactive sexual desire disorder (HSDD) and those with no female sexual dysfunction (FSD). The SIDI-F is a clinician-rated instrument consisting of 13 items designed to assess HSDD severity in women. The total score ranges from 0 to 51, with higher scores indicating better sexual function. Methods: Data from patients enrolled in a North American nontreatment study and a European nontreatment study were analyzed. Both studies were 4-week, prospective, multicenter trials designed to assess the reliability and validity of the SIDI-F. Only patients with HSDD or no FSD were included in this analysis. Receiver operating characteristics (ROC) analysis was used to determine the ability of the SIDI-F to differentiate between patients with HSDD and those with no FSD at baseline. Results: A total of 428 women were included in this analysis: 174 from North America (HSDD 113, no FSD 61) and 254 from Europe (HSDD 130, no FSD 124). In the North American study, a SIDI-F cutoff score of 33 minimized the difference between sensitivity (94.7%) and specificity (93.4%). In the European study, SIDI-F cutoff scores of both 33 and 34 minimized the difference between sensitivity (95.2%) and specificity (94.4%). Conclusions: In appropriately screened women, a SIDI-F score of ≤33 indicates the presence of HSDD. [ABSTRACT FROM AUTHOR]

Published
2010
Full Text
View/download PDF

39. Eating disorders and Axis I psychiatric comorbidity in amenorrheic women.

Author

Verri A, Nappi RE, Cecchini AP, Vallero E, Luzi S, and Zara C

Abstract

OBJECTIVE: The present study aimed to investigate the relationship between secondary amenorrhea due to different etiologic mechanisms, eating disorders, and psychiatric morbidity in a nonpsychiatric population observed in a gynecological department. METHOD: Amenorrheic women (n = 95) with hypogonadotropic, hyperandrogenic, and hyperprolactinemic features were interviewed individually using the SCID-R (Structured Clinical Interview for DSM-III-R) to diagnose Axis I disorders including mood disorders, anxiety disorders, somatoform disorders, adjustment disorders, and eating disorders. Binge eating disorder was diagnosed according to DSM-IV criteria. RESULTS: The incidence of eating disorders was significantly higher in hypogonadic women than in hyperandrogenic and hyperprolactinemic subjects (chi 2 = 23.03, p < .003). However, we also found a high percentage of hyperandrogenic women suffering from an eating disorder (40.9%) with a prevalence of binge eating disorder (27.2%), while the only eating disorder described in the hyperprolactinemic group was the not otherwise specified. In addition, a marked psychiatric comorbidity was found in amenorrheic women suffering from an eating disorder but a similar trend of pathologies was also found in amenorrheic women, without any positive SCID diagnosis for an abnormal eating disorder. DISCUSSION: Our study demonstrated that a high incidence of eating disorders, mainly anorexia and binge eating, characterizes hypogonadic and hyperandrogenic women, respectively. In addition, secondary amenorrhea displays a wide spectrum of Axis I diagnoses, without a significant comorbidity with eating disorders. Whether or not the endocrine findings related to the amenorrheic condition constitute a common background for the occurrence of psychopathology or, alternatively, the presence of psychiatric disturbances may contribute to the development of menstrual dysfunction remain to be clarified. [ABSTRACT FROM AUTHOR]

Published
1998
Full Text
View/download PDF

42. The effect of vulvovaginal atrophy on women's quality of life from an Italian cohort of the EVES study

Author

Rossella E. Nappi, Chiara Benedetto, Raffaella Ribaldone, Costantino Di Carlo, Angela Maria Becorpi, Francesco De Seta, Anna Maria Paoletti, Marco Gambacciani, Nappi, Re, Di Carlo, C, Becorpi, Am, Gambacciani, M, De Seta, F, Ribaldone, R, Benedetto, C, and Paoletti, Am

Subjects
Gerontology, Vaginal Diseases, EQ5DL, DIVA, Vulvovaginal atrophy, Severity of Illness Index, Vulva, Cohort Studies, 03 medical and health sciences, Italy, postmenopause, quality of life, vulvovaginal atrophy, 0302 clinical medicine, Quality of life, Early Medical Intervention, Post-hoc analysis, Medicine, Humans, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, Middle Aged, humanities, Postmenopause, Dyspareunia, 030220 oncology & carcinogenesis, Cohort, Vagina, Quality of Life, Female, Gynecological Examination, Vulvar Diseases, Atrophy, business
Abstract

ulvovaginal atrophy (VVA) has an impact on the quality of life (QoL) of women. This post hoc analysis of the EVES study provides an overview of the QoL in postmenopausal Italian women in relation with VVA severity. We included 1066 women attending menopause/gynaecologic centres. A face-to-face survey (including QoL and sexual life questionnaires), joining an objective gynaecological examination to confirm VVA, were performed. The 65.5% of the participants presented severe vaginal, vulvar and/or urinary symptoms; an 86.9% had an objective confirmed VVA. Women with severe symptoms presented with significantly worse QoL scores than the women without. We found there were moderately significant correlations between vaginal and vulvar symptoms' severity and lower overall DIVA QoL scores (p

Published
2019

43. Sexual function after fractional microablative CO2laser in women with vulvovaginal atrophy

Author

Stefano Salvatore, F. Lagona, Massimo Candiani, U. Leone Roberti Maggiore, Rossella E. Nappi, Simone Ferrero, Marta Parma, R. Chionna, Massimo Origoni, Nicola Zerbinati, Salvatore, S, Nappi, Re, Parma, M, Chionna, R, Lagona, F, Zerbinati, N, Ferrero, S, Origoni, Massimo, Candiani, Massimo, and Maggiore, Ul

Subjects
medicine.medical_specialty, Sexual Dysfunction, Visual analogue scale, Sexual Behavior, Physiological, vaginal dryness, menopause, sexual function, Vulvovaginal atrophy, Vulva, vulvovaginal atrophy, Quality of life, Fractional CO2 Laser, medicine, Humans, Dysuria, Prospective Studies, dyspareunia, sexual intercourse, Aged, Atrophy, Female, Lasers, Gas, Middle Aged, Patient Satisfaction, Postmenopause, Quality of Life, Sexual Dysfunction, Physiological, Vagina, Obstetrics and Gynecology, Prospective cohort study, Medicine (all), Gynecology, Co2 laser, business.industry, Lasers, General Medicine, Vaginal Itching, Gas, medicine.symptom, business, Sexual function
Abstract

Objective To investigate the effects of fractional microablative CO2 laser on sexual function and overall satisfaction with sexual life in postmenopausal women with vulvovaginal atrophy (VVA).Method This prospective study included 77 postmenopausal women (mean age 60.6 ± 6.2 years) treated for VVA symptoms with the fractional microablative CO2 laser system (SmartXide2 V2LR, Monalisa Touch, DEKA, Florence, Italy). Sexual function and quality of life were evaluated with the Female Sexual Function Index (FSFI) and the Short Form 12 (SF-12), respectively, both at baseline and at 12-week follow-up. A 10-mm visual analog scale was used to measure the overall satisfaction with sexual life and the intensity of VVA symptoms (vaginal burning, vaginal itching, vaginal dryness, dyspareunia and dysuria) before and after the study period.Results We observed a significant improvement in the total score and the scores in each specific domain of the FSFI at 12-week follow-up compared to baseline (p < 0.001). After...

Published
2014

44. Moderate Alcohol Intake, Genital Vascularization, and Sexuality in Young, Healthy, Eumenorrheic Women. A Pilot Study

Author

Bruno Battaglia, Roberto Paradisi, Cesare Battaglia, Stefano Venturoli, Fulvia Mancini, Rossella E. Nappi, Battaglia C., Battaglia B., Mancini F., Nappi RE., Paradisi R., and Venturoli S.

Subjects
Adult, medicine.medical_specialty, medicine.biofluid, Alcohol Drinking, Urology, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Physiology, Pilot Projects, Orgasm, Young Adult, Endocrinology, medicine, Humans, Sexual stimulation, Sex organ, Genitalia, Vascular Response of Clitoral Arteries, Menstrual Cycle, Menstrual cycle, Ultrasonography, media_common, Gynecology, Vaginal lubrication, Doppler, Beck Depression Inventory, Genitalia, Female, Psychiatry and Mental health, medicine.anatomical_structure, Reproductive Medicine, Labia minora, Female, Alcohol, Psychology, Sexual function, Sexuality
Abstract

Introduction. The relationship between alcohol and sexual function is complex and not completely understood. Aim. To evaluate (in the early follicular phase and independently from sexual stimulation) in young, eumenorrheic, healthy, lean women the genital vascular effects of the light and moderate use of alcohol. Methods. Eighty-four women undertook, in the early follicular phase of the menstrual cycle (days 3-5), the administration of the two-factor Italian McCoy Female Sexuality (MFSQ) and the Beck Depression Inventory (BDI) questionnaires; ultrasonographic measurement of the carotid intima-media thickness (IMT); and color Doppler evaluation of the carotid, clitoral, and labia minora arteries. Hormonal (estradiol, androstenedione, and testosterone) and biochemical (lipids, glucose, and insulin) parameters were tested. Main Outcome Measures. The MFSQ and BDI questionnaires; the carotid IMT; the Pulsatility Index of internal carotid, clitoral, and labia minora arteries; blood pressure measurement; and hormonal and biochemical assays. Results. The subjects were divided in: nondrinkers (group I); current (>1 year) light drinkers—1-10 drinks/month (group II); and current moderate drinkers—11-20 drinks/month (group III). The majority of the studied parameters did not vary among the different groups. The mean BDI was normal in the studied women. However, the lowest values were observed in the moderate drinkers group. The MFSQ did not show any difference among all the studied women. However, the number of intercourses/week and the incidence of vaginal orgasm were significantly higher in group III (moderate drinkers). The relationship between the drinking habits and different parameters showed an inverse relationship with the BDI. Furthermore, the BDI inversely correlated with orgasm frequency and with orgasm intensity. Conclusions. Chronic slight/moderate alcohol consumption has no effects on genital vessels and vaginal lubrication. However, a moderate consumption of alcohol, through psychological and social disinhibiting effects, may favor sexual activities. Battaglia C, Battaglia B, Mancini F, Nappi RE, Paradisi R, and Venturoli S. Moderate alcohol intake, genital vascularization, and sexuality in young, healthy, eumenorrheic women. A pilot study. J Sex Med 2011;8:2334-2343.

Published
2011

45. Cigarette Smoking Decreases the Genital Vascularization in Young Healthy, Eumenorrheic Women

Author

Stefano Venturoli, Rossella E. Nappi, Nicola Persico, Cesare Battaglia, Fulvia Mancini, Roberto Paradisi, Bruno Battaglia, Alma Mater Studiorum Universita' di Bologna, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, AREA MIN. 06 - Scienze mediche, Da definire, Battaglia C., Battaglia B., Mancini F., Persico N., Nappi RE., Paradisi R., and Venturoli S.

Subjects
Adult, medicine.medical_specialty, Urology, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Clitoris, Vulva, Labia Minora, Imaging, Three-Dimensional, Endocrinology, Clitori, Ultrasound, Image Processing, Computer-Assisted, Humans, Medicine, Sexual stimulation, Sex organ, Ultrasonography, Doppler, Color, Orgasm, Testosterone, Menstrual cycle, media_common, Gynecology, business.industry, Smoking, Doppler, Genital Blood Flow, Arteries, Blood flow, Psychiatry and Mental health, medicine.anatomical_structure, Blood pressure, Reproductive Medicine, Regional Blood Flow, Labia minora, Female, business, Blood Flow Velocity
Abstract

Introduction. Cigarette smoking is a major health hazard and may impair the normal sexual response. Aim. To evaluate (in the early follicular phase, and independently from sexual stimulation) in young, eumenorrheic, healthy, lean women the general and genital vascular effects of the smoking habit. Methods. One hundred thirty-seven patients undertook, in the early follicular phase of the menstrual cycle (day 3-5): the administration of the two-factor Italian McCoy Female Sexuality Questionnaire (MFSQ); two-dimensional (2-D) color Doppler evaluation of the ophthalmic, carotid, uterine, clitoral, and labia minora arteries; three- dimensional (3-D) analysis of clitoral and labia minora vascularization; and blood pressure evaluation. Fasting blood samples were drawn to test plasma estradiol, androstenedione, and testosterone circulating levels. Main Outcome Measures. The two-factor Italian MFSQ; the pulsatility index (PI) of internal carotid, ophthalmic, uterine, clitoral, and labia minora arteries; the vascularization index (VI), the flow index (FI), and the vascularization flow index (VFI) of clitoral body and labia minora, blood pressure measurement, and hormonal assay. Results. The subjects were divided in: nonsmokers (Group I; N = 72); current (>2 years) light smokers—1 to 10 cigarettes/day—(Group II; N = 35); and current heavy smokers—> 10 cigarettes/day—(Group III; N = 30). The 2-D Doppler analysis of the ophthalmic and internal carotid arteries showed significant increased resistance in Group III compared with Group II and Group I. The genital vessels (uterine, clitoral, and labium minus arteries) showed the lowest PIs in the nonsmokers. The 3-D power Doppler histogram analysis of clitoral and labium minus blood flow showed the worst vascular indices (VI, FI, VFI) in the heavy smokers. Conclusions. Cigarette smoking may favor a reduced central and peripheral tissue perfusion with consequent increased risk of cerebrovascular and cardiovascular diseases and with genital vessels stiffness and impaired sexual performances. Battaglia C, Battaglia B, Mancini F, Persico N, Nappi RE, Paradisi R, and Venturoli S. Cigarette smoking decreases the genital vascularization in young healthy, eumenorrheic women. J Sex Med 2011;8:1717-1725.

Published
2011

46. Female Urinary Incontinence During Intercourse: A Review on an Understudied Problem for Women's Sexuality

Author

Stefano Uccella, Pierfrancesco Bolis, Rossella E. Nappi, Maurizio Serati, Stefano Salvatore, Serati, M, Salvatore, Stefano, Uccella, S, Nappi, Re, and Bolis, P.

Subjects
medicine.medical_specialty, Sexual Behavior, Urology, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Urinary incontinence, Orgasm, Endocrinology, Urinary Leakage, Quality of life, Surveys and Questionnaires, Epidemiology, medicine, Humans, media_common, Gynecology, Pelvic floor, Urinary Bladder, Overactive, business.industry, Obstetrics, Incidence (epidemiology), Coitus, Pelvic Floor, medicine.disease, Urodynamics, Psychiatry and Mental health, Urinary Incontinence, medicine.anatomical_structure, Reproductive Medicine, Overactive bladder, Quality of Life, Female, medicine.symptom, business
Abstract

Introduction Coital urinary incontinence is a frequently underreported symptom, with a relevant impact on women's sexuality and quality of life. Aim This article will review the available evidence on incidence, pathophysiology, and treatment of coital urinary incontinence with the attempt to present the current state of the art. Methods PubMed was searched for reports about coital urinary incontinence that were published from 1970 to 2008, and the most relevant articles were reviewed. Main Outcome Measures Review on epidemiology, pathophysiology, diagnosis, and treatment of coital incontinence. Results The incidence of coital incontinence in incontinent women has been reported to range between 10% and 27%. At present, some evidence suggests an association between urinary leakage at penetration and urodynamic stress (USI) incontinence as well as urinary leakage during orgasm and detrusor overactivity (DO). When treatment for these conditions are based upon urodynamic findings, pelvic floor muscle training, surgery, and pharmacotherapy show satisfactory cure rates. Conclusions Coital urinary incontinence deserves much more attention in clinical practice: women should be specifically interviewed for this disturbance because it has a very negative impact on their sexuality. If a reliable urodynamic diagnosis is made, coital urinary incontinence at penetration can be cured in more than 80% of cases by surgery in the presence of USI. The form of coital incontinence during orgasm is curable by antimuscarinic treatment in about 60% of cases when associated with DO. Serati M, Salvatore S, Uccella S, Nappi RE, and Bolis P. Female urinary incontinence during intercourse: A review on an understudied problem for women's sexuality. J Sex Med 2009;6:40–48.

Published
2009

47. Italian position statement on hormone replacement therapy following the National Conference on Menopause and Hormone Replacement Therapy, Villa Tuscolana, Frascati (Rome), May 8–9, 2007

Author

M. L. Brandi, Carmela Nappi, Stefano Lello, G. B. Melis, Felice Petraglia, G. Rosano, Maria Grazia Modena, P. Sismondi, Secondo Guaschino, Giovanni Serra, Tommaso Simoncini, F. Tonelli, C. Mencacci, Andrea Ricardo Genazzani, Stefano Taddei, Angela Maria Becorpi, R. Anniverno, Marco Gambacciani, R. E. Nappi, S. Pecorelli, Nicoletta Biglia, Marco Massobrio, Genazzani, Ar, Gambacciani, M, Simoncini, T, Anniverno, R, Becorpi, Am, Biglia, N, Brandi, Ml, Guaschino, Secondo, Lello, S, Massobrio, M, Melis, Gb, Mencacci, C, Modena, Mg, Nappi, C, Nappi, Re, Pecorelli, S, Petraglia, F, Rosano, Gm, Serra, Gb, Sismondi, P, Taddei, S, and Tonelli, F.

Subjects
Position statement, Gynecology, Pediatrics, medicine.medical_specialty, Estrogens, Female, Hormone Replacement Therapy, Humans, Menopause, Perimenopause, Postmenopause, Progestins, Endocrinology, Diabetes and Metabolism, Endocrinology, Obstetrics and Gynecology, business.industry, medicine.disease, Diabetes and Metabolism, Obstetrics and gynaecology, Transgender hormone therapy, medicine, business
Abstract

After the publication of the randomized WHI trial in July 2002, the convictions regarding HRT and menopause, which had been acquired over many years, started to waver. Beforehand, the majority of t...

Published
2007

48. Sexual Function and Endocrine Profile in Fertile Women With Type 1 Diabetes

Author

Marina Scavini, Francesco Montorsi, Alberto Briganti, Giada Licata, Roberto Lanzi, Andrea Salonia, Elisa Gatti, Emanuele Bosi, Patrizio Rigatti, Marina Pontillo, Giovanna Petrella, Rossella E. Nappi, Salonia, Andrea, Lanzi, R, Scavini, M, Pontillo, M, Gatti, E, Petrella, G, Licata, G, Nappi, Re, Bosi, Emanuele, Briganti, A, Rigatti, P, and Montorsi, Francesco

Subjects
Adult, medicine.medical_specialty, Sexual Behavior, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Physiology, Luteal Phase, Luteal phase, chemistry.chemical_compound, Dehydroepiandrosterone sulfate, Surveys and Questionnaires, Internal medicine, Follicular phase, Internal Medicine, medicine, Humans, Sexual Dysfunctions, Psychological, Menstrual cycle, media_common, Advanced and Specialized Nursing, Type 1 diabetes, Depression, business.industry, Testosterone (patch), medicine.disease, Hormones, Sexual Dysfunction, Physiological, Diabetes Mellitus, Type 1, Endocrinology, Sexual dysfunction, Follicular Phase, chemistry, Female, medicine.symptom, business, Sexual function
Abstract

OBJECTIVE - Aims of this study were 1) to assess sexual function and endocrine profile among fertile type 1 diabetic women during the follicular and luteal phases of the menstrual cycle, 2) to compare these results with those obtained among healthy fertile women who served as control subjects, and 3) to explore the correlations between sexual function and endocrine milieu among patients and control subjects during the follicular and luteal phases of the menstrual cycle. RESEARCH DESIGN AND METHODS - Fifty fertile women with type 1 diabetes and 47 healthy control subjects completed a semistructured medical interview and filled in self-administered validated instruments to evaluate sexual function, depression, and sexual distress. Venous blood samples were drawn to measure glycated hemoglobin and an endocrine profile during either the follicular or the luteal phase of the menstrual cycle. RESULTS - Type 1 diabetic women had decreased sexual function and increased sexual distress compared with control subjects during the luteal, but not the follicular, phase of the menstrual cycle. During the follicular phase, patients had lower estrogenic basal tone, lower "weak" androgen (namely Delta(4)-androstenedione and dehydroepiandrosterone sulfate) production, and lower free-triiodothyronine and free-thyroxine levels compared with control subjects. During the luteal phase, total testosterone levels were higher in patients than control subjects, while 17 beta-estradiol and progesterone levels were lower in patients than control subjects. CONCLUSIONS - Among type 1 diabetic women, sexual function and sexual distress vary according to the phase of the menstrual cycle. This finding may have implications on the clinical assessment of sexual function in type 1 diabetic women, OBJECTIVE - Aims of this study were 1) to assess sexual function and endocrine profile among fertile type 1 diabetic women during the follicular and luteal phases of the menstrual cycle, 2) to compare these results with those obtained among healthy fertile women who served as control subjects, and 3) to explore the correlations between sexual function and endocrine milieu among patients and control subjects during the follicular and luteal phases of the menstrual cycle. RESEARCH DESIGN AND METHODS - Fifty fertile women with type 1 diabetes and 47 healthy control subjects completed a semistructured medical interview and filled in self-administered validated instruments to evaluate sexual function, depression, and sexual distress. Venous blood samples were drawn to measure glycated hemoglobin and an endocrine profile during either the follicular or the luteal phase of the menstrual cycle. RESULTS - Type 1 diabetic women had decreased sexual function and increased sexual distress compared with control subjects during the luteal, but not the follicular, phase of the menstrual cycle. During the follicular phase, patients had lower estrogenic basal tone, lower "weak" androgen (namely Delta(4)-androstenedione and dehydroepiandrosterone sulfate) production, and lower free-triiodothyronine and free-thyroxine levels compared with control subjects. During the luteal phase, total testosterone levels were higher in patients than control subjects, while 17 beta-estradiol and progesterone levels were lower in patients than control subjects. CONCLUSIONS - Among type 1 diabetic women, sexual function and sexual distress vary according to the phase of the menstrual cycle. This finding may have implications on the clinical assessment of sexual function in type 1 diabetic women

Published
2006

49. Women's sexual dysfunction: a pathophysiological review

Author

F. Federghini, Ricardo Munarriz, Irwin Goldstein, Vincenzo Mirone, R. Chionna, Richard Naspro, Andrea Salonia, F. Montorsi, Alberto Briganti, Rossella E. Nappi, Patrizio Rigatti, Salonia, Andrea, Munarriz, Rm, Naspro, R, Nappi, Re, Briganti, Alberto, Chionna, R, Federghini, F, Mirone, V, Rigatti, P, Goldstein, I, Montorsi, Francesco, Salonia, A, Briganti, A, Mirone, Vincenzo, and Montorsi, F.

Subjects
Adult, Nephrology, medicine.medical_specialty, Multiple Sclerosis, Urology, Sexual dysfunction, Pathophysiology, Postoperative Complications, Internal medicine, Multiple Sclerosi, medicine, Humans, Women, Sexual Dysfunctions, Psychological, Psychiatry, Spinal Cord Injuries, Aged, Gynecology, Spinal Cord Injurie, business.industry, Middle Aged, Treatment, Sexual Dysfunction, Physiological, Urinary Incontinence, Disfuncion sexual, Female, Postoperative Complication, medicine.symptom, business, Diagnosi, Human
Abstract

Sexual dysfunction (SD) in women is a multifactorial condition with anatomical, physiological, medical, psychological and social components. Well-designed, random-sample, community-based epidemiological investigations of women with SD are limited. Current data reveal that up to 76% of women have some type of SD [1,2]. Population census data from the USA suggest that approximate to 10 million American women aged 50-74 years self-report complaints of diminished vaginal lubrication, pain and discomfort during intercourse, decreased arousal, and difficulty achieving orgasm. Laumann et al. [3] found that SD is more prevalent in women (43%) than in men (31%), and is associated with various psycho-demographic characteristics, e. g. age, education, and poor physical and emotional health. More importantly, women's SD (WSD) is associated with negative experiences in sexual relationships. Recently, Brock et al. [4] reported the results of an international survey aimed at assessing both the prevalence and predictors of SD among mature men and women. Among a population of 4507 subjects, decreased sexual interest was reported by 34% of women and 18% of men; moreover, 19% of women and 11% of men reported that they did not consider sex pleasurable. Of the women interviewed, 23% reported inadequate lubrication, with a significant increase in this complaint in women aged 50-69 years [4].

Published
2004

50. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study

Author

Massimo Origoni, Massimo Candiani, U. Leone Roberti Maggiore, Stefano Salvatore, Rossella E. Nappi, Simone Ferrero, Nicola Zerbinati, Alberto Calligaro, Salvatore, Stefano, Nappi, Re, Zerbinati, N, Calligaro, A, Ferrero, S, Origoni, Massimo, Candiani, Massimo, and Leone Roberti Maggiore, U.

Subjects
medicine.medical_specialty, Visual analogue scale, Vaginal Diseases, Vaginal Dryness, Pilot Projects, Vulvovaginal atrophy, Vulvovaginal Atrophy, Vulva, Quality of life, medicine, Dysuria, Humans, Low-Level Light Therapy, Vaginal dryness, Co2 laser, business.industry, Lasers, Medicine (all), Obstetrics and Gynecology, General Medicine, Middle Aged, medicine.disease, Vaginal Itching, Menopause, Postmenopause, Dyspareunia, Treatment Outcome, Gas, Vagina, Atrophy, Feasibility Studies, Female, Lasers, Gas, Quality of Life, Vulvar Diseases, Laser Therapy, Low-Level, Low-Level, Physical therapy, Laser Therapy, medicine.symptom, business
Abstract

This pilot study aimed to assess the efficacy and feasibility of fractional CO2 laser in the treatment of vulvovaginal atrophy (VVA) in postmenopausal women.VVA symptoms were assessed before and after three applications of laser over 12 weeks in 50 women (age 59.6 ± 5.8 years) dissatisfied with previous local estrogen therapies. Subjective (visual analog scale) and objective (Vaginal Health Index Score, VHIS) measures were used during the study period to assess VVA. Quality of life was measured by using the SF-12. A subjective scale to evaluate the degree of pain related to the laser application and the degree of difficulty to perform the laser procedure was used.Fractional CO2 laser treatment was effective to improve VVA symptoms (vaginal dryness, vaginal burning, vaginal itching, dyspareunia, dysuria; p0.001) at 12-week follow-up, as well as the VHIS (13.1 ± 2.5 at baseline vs. 23.1 ± 1.9; p0.001). Both physical and mental scores of quality of life were significantly improved in comparison with baseline (p0.001). Satisfaction with the laser procedure was reported by 42 women (84%) and a minimal discomfort was experienced at the first laser application, mainly because of the insertion and the movements of the probe. Finally, the technique was very easy to perform in all women starting from the second application at week 4 and no adverse events were recorded during the study period.A 12-week treatment with the fractional CO2 laser was feasible and induced a significant improvement of VVA symptoms by ameliorating vaginal health in postmenopausal women. Further controlled studies should be performed to confirm the present data and to assess the long-term effects of the laser procedure on vaginal tissues.

Published
2014

Catalog

Books, media, physical & digital resources
See catalog results