Sexual functioning in patients with psoriasis: the role of body dissatisfaction and cognitive biases toward sexuality.

Psoriasis is a chronic disease, involving skin and joints, characterized by inflamed lesions. Psoriasis negatively impacts the patients' quality of life due to the physical, emotional, and social burden that accompanies this condition. Also, psoriasis is associated with a number of psychiatric comorbidities, including sexual dysfunctions. The present study investigates the variables associated with sexual functioning in psoriasis patients. One-hundred-three psoriasis patients and 101 matched control subjects took part in the present study. Each participant completed five self-report measures investigating the presence of depression, anxiety and stress symptoms, body image, quality of life, and sexual experience. Our results show that differences in sexual activity, but not in sexual functioning, emerged between groups. In men with psoriasis, more sexual difficulties were associated with more negative automatic thoughts about sexuality. In women, more sexual difficulties were associated with more negative automatic thoughts; anxiety, depression, and stress; severity of symptoms; comorbid disease; age; quality of life. Our findings expand the current knowledge about sexual functioning in psoriasis and shed light on specific cognitive, psychological, and demographic variables associated with sexual impairment in men and women with psoriasis.

The effect of exposure to emotional violence on sexual function, sexual quality of life and psychological well-being in women: Structural equation modeling.

Emotional violence is all of the destructive behaviors that humiliate the individual and cause him/her to feel under pressure to disrupt mental health. These destructive behaviors can affect women's sexuality. In this study, it was aimed to determine the effect of exposure to emotional violence on sexual function, sexual life quality, and psychological well-being in women. The study was conducted in a descriptive and relational screening model. The sample of the study consisted of 213 women. Personal information forms, the female sexual function index, the sexual quality of life questionnaire, the exposure to emotional violence scale, and the psychological well-being scale were used in the study. Structural equation modeling was used to determine the direct and indirect predictive power of the independent variable on the dependent variable. The effect of exposure to emotional violence on psychological well-being (ß = -0.323; p < 0.001), and the effect of quality of sexual life on psychological well-being were statistically significant (ß =0.315; p < 0.001). Moreover, the effect of exposure to emotional violence on sexual life quality was determined to be statistically significant (ß = -0.665; p < 0.001). The effect of quality of sexual life on female sexual function was statistically significant (ß = -0.288; p = 0.002). Furthermore, while the effect of psychological well-being on the female sexual function index was not statistically significant (ß = -0.101; p = 0.266), the effect of exposure to emotional violence scale on the female sexual function index was statistically significant (ß = -0.087; p = 0.373). The mediating role of exposure to emotional violence in the relationship between sexual life quality and psychological well-being was high. Furthermore, the sexual life quality of 43.6 % of women was explained by exposure to emotional violence. On the other hand, 28.7 % of psychological well-being score was explained by the sexual life quality and exposure to emotional violence.

Sexual health in long-term breast cancer survivors: a comparison with female population controls from the HUNT study.

PURPOSE: Sexual health is an important aspect of quality of life. Knowledge concerning sexual health in long-term breast cancer survivors (BCSs) is limited. This study compared sexual health in BCSs 8 years after diagnosis with similarly aged controls and examined the impact of menopausal status at diagnosis and systemic breast cancer treatments on sexual health. METHODS: Women aged 20-65 years when diagnosed with stage I-III breast cancer in 2011-2012 were identified by the Cancer Registry of Norway (n = 2803) and invited to participate in a nationwide survey. Controls were women from the Trøndelag Health Study (HUNT4). Sexual functioning and sexual enjoyment were measured by the EORTC QLQ-BR23 subscales scored from 0 to 100, and sexual discomfort by the Sexual Activity Questionnaire scored from 0 to 6. Linear regression analyses with adjustments for sociodemographic and health-related variables were performed to compare groups. Differences of ≥ 10% of range score were considered clinically significant. RESULTS: The study samples consisted of 1241 BCSs and 17,751 controls. Sexual enjoyment was poorer (B - 13.1, 95%CI - 15.0, - 11.2) and discomfort higher (B 0.9, 95%CI 0.8, 1.0) among BCSs compared to controls, and larger differences were evident between premenopausal BCSs and controls (B - 17.3, 95%CI - 19.6, - 14.9 and B 1.2, 95%CI 1.0, 1.3, respectively). BCSs treated with both endocrine- and chemotherapy had lower sexual functioning (B - 11.9, 95%CI - 13.8, - 10.1), poorer sexual enjoyment (B - 18.1, 95%CI - 20.7, - 15.5), and more sexual discomfort (B 1.4, 95% 1.3, 1.6) than controls. CONCLUSION: Sexual health impairments are more common in BCSs 8 years after diagnosis compared to similar aged population controls. During follow-up, attention to such impairments, especially among women diagnosed at premenopausal age and treated with heavy systemic treatment, is warranted.

Porn use and men's and women's sexual performance: evidence from a large longitudinal sample.

BACKGROUND: We examined whether young men and women differ in the relation between porn use and sexual performance (sexual self-competence, sexual functioning, and partner-reported sexual satisfaction). METHODS: We conducted a three-wave longitudinal study (spanning 2015-16-17) that involved a very large number of men and women in their early 20s (100 000 + French-speaking individuals; 4000 + heterosexual couples). RESULTS: The results revealed a twofold phenomenon. Among men, a higher frequency of porn use (wave 1) and increased porn use over time (waves 1-3) were associated with lower levels of sexual self-competence, impaired sexual functioning, and decreased partner-reported sexual satisfaction. In contrast, among women, higher and increasing frequencies of porn use were associated with higher levels of sexual self-competence, improved sexual functioning, and enhanced partner-reported sexual satisfaction (for some aspects). CONCLUSIONS: The findings reveal the irony that porn - a male-dominated industry that targets a male-dominated audience - is associated with the erosion of the quality of men's sex lives and the improvement of women's sex lives.

Vaginal changes, sexual functioning and distress of women with locally advanced cervical cancer treated in the EMBRACE vaginal morbidity substudy.

OBJECTIVE: The EMBRACE-vaginal morbidity substudy prospectively evaluated physician-assessed vaginal changes and patient-reported-outcomes (PRO) on vaginal and sexual functioning problems and distress in the first 2-years after image-guided radio(chemo)therapy and brachytherapy for locally advanced cervical cancer. METHODS: Eligible patients had stage IB1-IIIB cervical cancer with ≤5 mm vaginal involvement. Assessment of vaginal changes was graded using CTCAE. PRO were assessed using validated Quality-of-Life and sexual questionnaires. Statistical analysis included Generalized-Linear-Mixed-Models and Spearman's rho-correlation coefficients. RESULTS: 113 eligible patients were included. Mostly mild (grade 1) vaginal changes were reported over time in about 20% (range 11-37%). At 2-years, 47% was not sexually active. Approximately 50% of the sexually active women reported any vaginal and sexual functioning problems and distress over time; more substantial vaginal and sexual problems and distress were reported by up to 14%, 20% and 8%, respectively. Physician-assessed vaginal changes and PRO sexual satisfaction differed significantly (p ≤ .05) between baseline and first follow-up, without further significant changes over time. No or only small associations between physician-assessed vaginal changes and PRO vaginal functioning problems and sexual distress were found. CONCLUSIONS: Mild vaginal changes were reported after image-guided radio(chemo)therapy and brachytherapy, potentially due to the combination of tumors with limited vaginal involvement, EMBRACE-specific treatment optimization and rehabilitation recommendations. Although vaginal and sexual functioning problems and sexual distress were frequently reported, the rate of substantial problems and distress was low. The lack of association between vaginal changes, vaginal functioning problems and sexual distress shows that sexual functioning is more complex than vaginal morbidity alone.

Sexual functioning beliefs, sexual satisfaction, and sexual functioning in women: a cross-sectional mediation analysis.

BACKGROUND: Sexual dysfunctional beliefs are known to be negative predictors of women's sexual functioning and sexual satisfaction, but little is known about the role that beliefs about sexual functioning play in women's sexual functioning and sexual satisfaction. AIM: The purpose of the present study was to examine the mediating role of sexual functioning in the relationship between women's beliefs about sexual functioning and sexual satisfaction. METHODS: A sample of 301 women was invited to participate in a web survey about female sexuality in May 2020. OUTCOMES: Participants completed the sociodemographic questionnaire, the Beliefs About Sexual Functioning Scale, the Sexual Satisfaction Scale for Women, and the Female Sexual Functioning Index. RESULTS: Sexual functioning was a significant mediator in the relationship between beliefs about sexual functioning and sexual satisfaction in women. When the dimensions of sexual functioning were considered as mediators, only sexual desire and absence of sexual pain were significant mediators in the relationship between beliefs about sexual functioning and sexual satisfaction in women. CLINICAL IMPLICATIONS: Negative beliefs about sexual functioning in women are associated with poor sexual functioning and lack of sexual satisfaction. Therefore, beliefs about sexual functioning should be assessed during the intervention for women's sexual difficulties and to increase sexual pleasure and satisfaction. In addition, special attention should be paid to women with problems with sexual desire and sexual pain when beliefs about sexual functioning are being assessed. STRENGTHS AND LIMITATIONS: This study is one of the first attempts to explore the role of beliefs about sexual functioning in women's sexual satisfaction and to examine the mediating role of sexual functioning. Limitations include the small sample size, the lack of a clinical sample, and the nonlongitudinal methodological approach. CONCLUSION: Beliefs about sexual functioning are a negative predictor of sexual functioning and sexual satisfaction in women. In addition, women with sexual pain and lack of sexual desire are more likely to have lower sexual satisfaction if they have more negative beliefs about sexual functioning.

Measurement invariance of the Arizona Sexual Experience Scale by sexual orientation: comparing the sexual functioning of gay and heterosexual individuals.

BACKGROUND: The assessment of sexual functioning requires accurate and reliable measures as well as short and easy to apply. The Arizona Sexual Experience Scale (ASEX), which provides a quick, easy, and nonintrusive assessment of sexual functioning in men and women, is a clear example of a commonly used scale that satisfies these qualities. AIM: The study sought to examine measurement invariance and differential item functioning (DIF) by sexual orientation of the Spanish version of the ASEX. METHODS: A confirmatory factor analysis was performed on a sample of 1600 adults (800 gay and 800 heterosexual individuals), testing measurement invariance of the ASEX by sexual orientation in men and women separately, and calculating its reliability and DIF. OUTCOMES: The measure provided by the Spanish version of the ASEX is reliable and valid for assessing the sexual functioning of gay men and lesbians, but comparisons by sexual orientation are not recommended for men. RESULTS: The results of the confirmatory factor analysis confirmed the unidimensional structure of the ASEX already found in the Spanish validation with heterosexual people. Measurement invariance showed that, in the men's sample, the factor structure of the ASEX only reached the weak level of invariance, whereas in the women's sample, strict invariance by sexual orientation was reached. The internal consistency reliability was adequate, with better coefficients in women than in men. No significant DIF was observed in either men or women. CLINICAL IMPLICATIONS: Clinicians should further their training in sexual and gender diversity as approaches such as affirmative LGBT psychotherapy gain popularity, and they must have access to assessment instruments that are psychometrically robust enough to be used with this population. STRENGTHS AND LIMITATIONS: This research has some limitations. Because the distribution was administered solely through social media platforms, those without access to social media were unable to participate. Beyond these restrictions, however, the findings are thought to be significant from a research and clinical perspective since measurement invariance is a step that is often excluded when using an instrument validated in a mostly heterosexual sample. CONCLUSION: Validating assessment tools in gay men and lesbians is essential because sexual functioning is a crucial concept in sexual health. The findings of this study suggest that the Spanish version of the ASEX offers valid and reliable measures of sexual functioning for both heterosexual and gay people, though there would be bias in comparing men of both orientations.

The role of self-compassion and relation satisfaction in the association between child sexual abuse and sexual functioning.

BACKGROUND: The current study is based on the established association between child sexual abuse (CSA) and self-compassion, and CSA and sexual functioning, with an overall goal to better understand how self-compassion explains the association between CSA and sexual functioning. AIM: The current study examined the role of self-compassion as a potential mediator, and relationship satisfaction as a potential moderator, in the association between CSA and sexual functioning among a nonclinical sample of men and women. METHODS: Participants completed an online survey assessing CSA, self-compassion, sexual functioning, and relationship satisfaction. The sample consisted of 914 individuals, of whom 582 reported currently being in a romantic relationship and were included in the current analysis. The majority of the sample was female (n = 534, 91.8%), with a mean age of 31.85 years (SD, 9.76). OUTCOMES: Self-compassion mediated the link between CSA and sexual dysfunction, and relationship satisfaction moderated this same link. RESULTS: Results indicate that self-compassion mediated the association between CSA and sexual functioning. In addition, there was a significant 2-way interaction between CSA and intimate relationship satisfaction predicting sexual functioning. Specifically, CSA was negatively associated with sexual functioning only when there were low levels of relationship satisfaction, whereas in the presence of average and high intimate relationship satisfaction, the association between CSA and sexual functioning was nonsignificant. CLINICAL IMPLICATIONS: Findings from the current study suggest that clinicians working with CSA survivors should take into account survivors' self-compassion and relational functioning when engaging in therapeutic work around their sexual dysfunction. STRENGTHS AND LIMITATIONS: The study included a nonclinical sample of individuals and used self-report measures, which are highly subjective and increase the possibility of social desirability biases. Additional research should be conducted among clinical samples and among couples to explore this model from a dyadic perspective. CONCLUSION: Our results highlight the importance of self-compassion and relationship satisfaction when considering sexual dysfunction following CSA.

Psychosexual development, sexual functioning and sexual satisfaction in long-term childhood cancer survivors: DCCSS-LATER 2 sexuality substudy.

OBJECTIVES: Childhood cancer may negatively impact childhood cancer survivors' (CCS) sexuality. However, this is an understudied research area. We aimed to describe the psychosexual development, sexual functioning and sexual satisfaction of CCS, and identify determinants for these outcomes. Secondarily, we compared the outcomes of a subsample of emerging adult CCS to the Dutch general population. METHODS: From the Dutch Childhood Cancer Survivor Study LATER cohort (diagnosed 1963-2001), 1912 CCS (18-71 years, 50.8% male) completed questions on sexuality, psychosocial development, body perception, mental and physical health. Multivariable linear regressions were used to identify determinants. Sexuality of CCS age 18-24 (N = 243) was compared to same-aged references using binomial tests and t-tests. RESULTS: One third of all CCS reported hindered sexuality due to childhood cancer, with insecure body the most often reported reason (44.8%). Older age at study, lower education, surviving central nervous system cancer, poorer mental health and negative body perception were identified as determinants for later sexual debut, worse sexual functioning and/or sexual satisfaction. CCS age 18-24 showed significantly less experience with kissing (p = 0.014), petting under clothes (p = 0.002), oral (p = 0.016) and anal sex (p = 0.032) when compared to references. No significant differences with references were found for sexual functioning and sexual satisfaction, neither among female CCS nor male CCS age 18-24. CONCLUSIONS: Emerging adult CCS reported less experience with psychosexual development, but similar sexual functioning and sexual satisfaction compared to references. We identified determinants for sexuality, which could be integrated in clinical interventions for CCS at risk for reduced sexuality.

Sexual functioning, sexual enjoyment, and body image in Norwegian breast cancer survivors: a 12-year longitudinal follow-up study and comparison with the general female population.

BACKGROUND: Given the scarcity of evidence concerning the long-term sexual health of breast cancer (BC) survivors (BC-Pop), we aimed to assess how BC treatments affect short- and long-term sexual functioning, sexual enjoyment, and body image, and compare with aged-matched women in the Norwegian general population (F-GenPop). MATERIAL AND METHODS: The 349 patients in BC-Pop treated at Trondheim University Hospital in 2007-2014, were assessed in clinical controls at the hospital; before starting radiotherapy (T1, baseline), immediately after ending radiotherapy (T2), and after 3, 6, and 12 months (T3-T5), and at a long-term follow-up 7-12 years after baseline (T6). Meanwhile, F-GenPop included 2254 age-matched women in the Norwegian general population. The impact of BC treatment on sexual functioning was examined using a Linear Mixed Model. Sexual functioning, sexual enjoyment, and body image were assessed with the EORTC's QLQ-BR23 scales and compared between the populations in the four age groups (30-49, 50-59, 60-69, and 70+ years) using means with 95% confidence intervals and Student t-test. Linear regression, adjusted for age and comorbidity was applied to estimate individual scores. RESULT: BC survivors treated with mastectomy had overall lower sexual functioning than patients who had received breast-conserving surgery (p = 0.017). Although BC survivors treated with chemotherapy had lower sexual functioning than those treated without chemotherapy at T1-T5 (p = 0.044), both groups showed the same level of functioning at T6. BC-Pop exhibited significantly poorer sexual functioning (p < 0.001), lower sexual enjoyment (p < 0.05), and better body image (p < 0.001) than F-GenPop in all age groups. CONCLUSION: The impact of specific BC treatments on sexual functioning was modest; only mastectomy had a persistent negative influence. Nevertheless, all age groups in BC-Pop displayed significantly poorer sexual functioning than F-GenPop at both 12 months and up to 12 years after treatment.

Stress and Depression Are Associated with Sexual Function and Satisfaction in Young Men Who Have Sex with Men.

Prior research suggests that better mental health and higher relationship quality are associated with better sexual function and satisfaction. Such insights can inform intervention development for mental, relationship, and sexual health concerns. This study examined the interactions among these variables in a racially and ethnically diverse group of young men who have sex with men (YMSM) in serious relationships (N = 348). Data were drawn from wave 5 of a longitudinal cohort study. We examined cross-sectional associations between depression and stress (predictors) and sexual function, sexual satisfaction, and anal discomfort (outcomes) and to what extent these associations were moderated by relationship quality. Higher endorsement of depression and stress was associated with worse sexual functioning, lower sexual satisfaction, and more anal discomfort. We also found that fewer negative interactions, stronger commitment, and higher relationship satisfaction were associated with better sexual functioning and higher sexual satisfaction. Higher relationship satisfaction and commitment were found to attenuate the association between stress and sexual satisfaction. Contrary to expectations, higher relationship satisfaction also showed a trend toward exacerbating the association between depression and sexual functioning. These results suggest that, for YMSM, high relationship satisfaction and commitment may protect sexual satisfaction from being negatively impacted by high stress. However, YMSM in highly satisfying relationships may experience poor sexual functioning associated with depression as particularly distressing. This study addressed a major gap in the literature by focusing on mental, relationship, and sexual health in a diverse sample. Future research should examine a wider range of sexual functioning outcomes and include minority stress in study design.

Sexual-related determinants of life satisfaction among married women: A cross-sectional study.

BACKGROUND AND AIM: Life satisfaction refers to the perceived satisfaction of individuals concerning various aspects of their lives. The present study investigated the predictive role of sexual-related determinants in life satisfaction among married women. METHODS: A cross-sectional study was conducted from August to November 2021. A total of 350 married women with at least six months of cohabitation with husbands were included in the study. The study utilized a multi-stage random sampling method from 10 comprehensive health centers in Qazvin, Iran. Scores on the Emotional Intimacy Questionnaire (EIQ), Dyadic Sexual Communication Scale (DSCS), Female Sexual Distress Questionnaire (FSDQ), Female Sexual Quality of Life Scale (FSQLS), Female Sexual Function Index (FSFI), and Life Satisfaction Scale (LSS) were assessed. Data were analyzed using univariable and multivariable linear regression models with a significance level of p < 0.05. RESULTS: The mean age of participants was 33.77 years (SD = 9.77) and they had been married for an average of 10.21 years (SD = 9.93). The mean scores on the LSS were 20.16 (out of 35; SD = 6.79). Based on the multivariable linear regression model adjusted for socio-demographic characteristics, the two strongest predictors of life satisfaction among Iranian married women were marital intimacy (ß = 0.49, p < 0.001) and sexual functioning (ß = 0.17, p = 0.009). Together, these variables explained 45% of variance in life satisfaction. CONCLUSION: Given that marital intimacy and sexual functioning were the most significant sexual-related determinants of life satisfaction among married women, designing and implementing interventions which increase women's marital intimacy and sexual functioning might improve married women's life satisfaction.

Sexual script flexibility after a prostate cancer diagnosis: Implications for sexual satisfaction.

PURPOSE: To investigate the relationship among sexual functioning, sexual script flexibility, and sexual satisfaction in individuals diagnosed with prostate cancer. DESIGN: Cross-sectional online survey. PARTICIPANTS: Sixty-one men diagnosed with localized prostate cancer. METHODS: Online survey of sexual functioning, sexual script flexibility, and sexual satisfaction. Ordinal logistic regression investigated predictors of sexual satisfaction. FINDINGS: Greater sexual script flexibility was associated with a greater likelihood of being sexually satisfied. CONCLUSIONS: Helping patients explore different ways of being sexual after treatment could help with sexual satisfaction maintenance. IMPLICATIONS: Patients' sexual satisfaction may benefit from discussions of issues related to sexuality and ways to work around treatment-related sexual dysfunction with healthcare providers.

The mediating role of self-directed ageism in sexual health among Jewish-Israeli older people.

This article examines the relationships between physical health, personal resilience and healthy sexuality in older adults, and the mediating role of self-directed ageism in these relationships. Healthy sexuality, which encompasses sexual partnership satisfaction, sexual behaviors, successful sexual functioning, few negative changes, and few sexual health concerns, is important in old age. Five hundred Jewish-Israeli women and men, aged 60 years and over, participated in the study. Five questionnaires were administered that examined the number of diseases, level of resilience, self-perceptions of aging, and sexual relationships and activities. The data were analyzed using multiple linear and logistic regressions, and path analysis for the mediating role of self-directed ageism. The results showed that higher levels of resilience were positively related to aspects of sexual health, while reporting more diseases and higher self-directed ageism were negatively related to sexual health. Self-directed ageism mediated the relationships between resilience and number of diseases and sexual health. The findings supported the biopsychosocial model of healthy sexuality. It was concluded that sexual health in older age may be promoted by fostering resilience, promoting good health, and reducing self-directed ageism.

Association of levonorgestrel intrauterine devices with stress reactivity, mental health, quality of life and sexual functioning: A systematic review.

Levonorgestrel-intrauterine-devices (LNG-IUD) are one of the most used contraceptive methods worldwide. While several reviews exist on how LNG-IUDs impact physiology and gynaecological functions, this systematic review focuses on stress, mental health, quality of life, sexual functioning, and effects on brain architecture. While data on stress is scarce, results on mental health are ambiguous. More consistently, LNG-IUD use seems to improve quality of life and sexual functioning. No studies highlighting the consequences of LNG-IUD use on the brain were found. The reviewed studies are characterized by a substantial variation in approaches, participant groups, and study quality. More high-quality research assessing the effects of LNG-IUD on mental health, including response to stressors and brain function and structure, is needed to identify women vulnerable to adverse effects of LNG-IUD, also in comparison to oral contraceptives, and to empower women to make more informed choices concerning hormonal contraception.

Sexual dysfunction among males and females with bipolar disorder and healthy subjects: The burden of illness severity.

OBJECTIVES: Sexual dysfunction has wide-ranging impacts on the person's functioning and quality of life, being associated with higher severity of psychiatric illnesses and poor therapeutic response. Given the paucity of data on this topic in bipolar disorder (BD), we investigated sexual functioning among males and females with BD and healthy controls (HCs) as well as whether illness severity markers and subthreshold mood symptoms were associated with sexual dysfunctions in BD patients. METHODS: The study included 80 BD outpatients and 70 HCs. Sexual functioning was evaluated using the validated, gender-specific Changes in Sexual Functioning Questionnaire (CSFQ-14). RESULTS: BD patients had a significantly poorer sexual functioning than HCs (p < 0.00001). The odds of sexual dysfunction doubled given a one-unit increase in the number of suicide attempts (adjusted OR = 2.01, 95% CI:1.23-3.55; p < 0.01) and increased by 60% for every additional hospitalization (p < 0.05). Greater illness duration was associated with arousal/orgasmic (p < 0.05) and overall sexual dysfunctions (p < 0.01). BD patients with more mixed or (hypo)manic episodes had a lower likelihood of libido loss and arousal/orgasmic disturbances (p < 0.01), respectively. Higher levels of subthreshold depressive symptoms increased by 20% the odds of sexual interest/frequency dysfunctions (p < 0.05), and up to 60% regarding orgasmic disturbances (p < 0.01). CONCLUSIONS: Sexual functioning may be a useful proxy of illness severity as well as a relevant dimension to more deeply characterize BD patients. Further studies are warranted to replicate our findings, to evaluate temporal associations between sexual dysfunctions and illness severity across the BD mood and treatment spectrums and to explore neurobiological underpinnings of these associations.

Psychosexual Development and Sexual Functioning in Young Adult Survivors of Childhood Cancer.

BACKGROUND: Childhood cancer and its treatment can impair survivors' development throughout life, particularly psychosexual development, which can be affected in complex ways and is crucial for survivors' well-being. Yet, research is scarce. AIM: This study assessed psychosexual development (milestone attainment, age at attainment, perceived timing) in young adult survivors of childhood cancer. It further examined sexual satisfaction and sexual functioning, and whether survivors' perceived timing of sexual debut was related to satisfaction or functioning. METHODS: A registry-based nationwide survey was completed by N = 492 German survivors of childhood cancer (age 21-26 years, 6-26 years postdiagnosis). They completed standardized measures of psychosexual milestones (eg, first kiss, sexual debut), sexual satisfaction, and sexual functioning. Psychosexual development was compared to normative data (N = 1,533). OUTCOMES: Psychosexual development, sexual satisfaction, and sexual functioning were the primary outcome measures. Psychosexual development was characterized in three ways: milestone attainment (yes/no), age at attainment, perceived timing ("right" time, too early/late). RESULTS: Milestone attainment was comparable to normative data, except for sexual debut: Survivors were less often experienced (82.5% vs 88%; P = .002) and older at sexual debut (17.4 vs 16.2 years; g = 0.55), but most survivors (58.3%) perceived their timing as "right." Survivors of brain tumors were least likely to have had their sexual debut, but if experienced age at sexual debut was similar to other survivors. Female survivors were somewhat more experienced than males (eg, first kiss, first relationship; <10% difference), but they were somewhat older when they first kissed (g = 0.26). Age at diagnosis was unrelated to milestone attainment. Perceived early/late sexual debut was related to lower satisfaction in female survivors (P = .026), but unrelated to sexual dysfunction. Instead, partnered men reported particularly low dysfunction whereas women reported similar levels of sexual dysfunction irrespective of their relationship status (P = .049). Overall, sexual functioning was favorable (60.2%: not/barely problematic). CLINICAL IMPLICATIONS: Most survivors reported favorable sexual satisfaction and functioning, but a minority of survivors may need supportive services. STRENGTHS & LIMITATIONS: This project represents one of few large-scale studies on psychosexual development in childhood cancer survivors relative to normative data, and is the first to link development to sexual satisfaction/functioning. Assessing satisfaction/functioning with validated, but brief measures limits detailed insights, but was inclusive of any sexual orientation. Medical background information based on registry data was limited. CONCLUSION: Results showed normative psychosexual development (except for sexual debut) in most survivors. A self-determined attitude toward sexuality (ie, engaging in sexual activities at the "right" time) may generally determine positive sexual experiences. Lehmann V, Gerhardt CA, Baust K, et al. Psychosexual Development and Sexual Functioning in Young Adult Survivors of Childhood Cancer. J Sex Med 2022;19:1645-1654.

Psychological and sexual distress in rectal cancer patients and partners.

BACKGROUND: Rectal cancer (RC) patients experience unique sources of distress, including sexual dysfunction and body image concerns, which can also cause distress among partners. This preliminary study investigated patterns of psychological distress, sexual functioning, sexual distress, and relationship satisfaction among RC patient-partner couples at pivotal points during cancer treatment. METHODS: Twenty couples participated (N = 40). Patients and partners completed a series of validated measures of psychological distress (ET), sexual functioning (FSFI; IIEF), sexual distress (GMSEX; Sexual Distress Scale) and relationship satisfaction (GMREL) at time of diagnosis, 3 weeks after radiation, 4 weeks post-surgery, and after chemotherapy and surgery for ostomy closure. Descriptive statistics, t-tests, and repeated-measures ANOVA were used to analyze scores over time, first for patients and partners, and then by sex. RESULTS: Relationship satisfaction remained elevated over time. In this sample, 55% of patients and 78.9% of partners reported clinically significant rates of psychological distress at diagnosis, which decreased to 23% and 46% respectively at the last assessment. Sexual satisfaction and distress worsened for patients and partners between baseline and surgery for ostomy closure. Both male and female participants reported statistically significant declines in sexual function from baseline to end of treatment (p < 0.05). DISCUSSION: Relative to relationship satisfaction, psychological and sexual health outcomes seem more vulnerable to the effects of RC treatment during the first year after diagnosis, both for patients and partners and for men and women. Results support the need for psychosocial care and sexual education/counseling for couples coping with RC.

Effectiveness of psychoeducation intervention among women with gynecological cancer: a systematic review and meta-analysis of randomized controlled trials.

Psychoeducation interventions have been suggested to improve sexual functioning and quality of life. The aim of this study was to examine the effects of the psychoeducation intervention on quality of life, sexual function, and psychological outcomes; and to identify the critical components of psychoeducation intervention for women with gynecological cancer. This study was a systematic review and meta-analysis. Psychoeducation interventions were searched using six English databases, eligible studies were extracted, and the risk of bias was evaluated by two authors independently. A random effects model was used to examine the intervention effects. We conducted subgroup analysis and meta-regression to assess the variables underlying the heterogeneity. In total, eight trials were identified, and 1128 participants were included. Women who received the psychoeducation intervention had better quality of life (standardized mean difference (SMD) = 0.59, 95% confidence interval (CI): 0.22, 0.97), sexual functioning (SMD = 0.63, 95% CI: 0.27, 0.99), and psychological outcomes (i.e., anxiety and depression (SMD = - 0.27, 95% CI: - 0.09, - 0.44)). Interventions that combined lecture-based, skill practical, discussion, and counseling were conducted using an online format and were delivered by a team of health professionals that had higher scores of qualities of life. Additionally, involving significant others in the intervention improved sexual functioning. Psychoeducation interventions effectively improve quality of life, sexual functioning, anxiety, and depression. Incorporating lecture-based, practical skills, discussion, and counseling through an online format and involving significant others are beneficial for improving the quality of life and sexual functioning among women with gynecological cancer.

Sexual Health and the Pandemic Crisis: Testing the Role of Psychological Vulnerability/Protective Factors on Sexual Functioning and Sexual Distress During a Critical Life Period in Portugal.

Recent findings suggest that the current COVID-19 pandemic has a potential negative impact in several areas of life, including sexual health. However, less is known about the psychological dimensions that may work as vulnerability/protective factors for the development of sexual problems in the current pandemic. The current study used a longitudinal design to examine the role played by personality trait factors (neuroticism, extraversion) as well as psychosexual factors (sexual beliefs) in predicting sexual functioning and sexual distress across time during the current pandemic crisis. A total of 528 individuals (337 women) completed a web survey assessing sexual health indicators and psychological factors. The first wave was conducted during the confinement period in Portugal (N = 528) between May and June 2020 and the second four months later (N = 146), when strict confinement rules were over. Generalized estimating equations (GEE) were used to examine the ability of psychological factors to predict sexual functioning and distress across time, while controlling for age and gender. Results indicated that sexual distress at time point 2 was lower than during confinement, and men had lower levels of sexual functioning post-confinement while no significant difference was observed for women. Moreover, higher levels of neuroticism and age-related beliefs significantly predicted lower sexual functioning as well as higher sexual distress, whereas lower levels of extraversion predicted lower sexual functioning after controlling for age and gender effects. Findings support the role of psychological vulnerability factors to predict sexual problems across time and may have important implications in the prevention and treatment of sexual dysfunctions.